. 






I 



,L« 



GUIDE TO THERAPEUTICS 



AND 



MATERIA MEDIOA. 



BY 
ROBERT FARQUHARSON, M.D. Edin., 

F.R.C.P. Lond., 

LECTURER ON MATERIA MEDICA AT ST. MARY'S HOSPITAL MEDICAL 

SCHOOL, ETC. 



SECOND AMERICAN EDITION, REVISED BY THE AUTHOR. 



ENLARGED AND ADAPTED TO THE U. S. PHARMACOPOEIA 



BY 
FRANK WOODBURY, M.D., 



PHYSICIAN TO THE GERMAN HOSPITAL, PHILADELPHIA. 



(J 



s{S*» 




ft 



^T OF CON 



fijVo. £- y C?l 



PHILADELPHIA: 

HENRY C. LE A. 

1879. 



fr 






Entered according to the Act of Congress, in the year 1879, by 

HENEY C. LEA, 

hi the Office of the Librarian of Congress. All rights reserved. 



COLLINS, PRINTER 



EDITOR'S PREFACE. 



There is no more encouraging evidence of progress 
in medical science than the growing desire of the 
profession for exact information concerning the action 
of remedial agents. A tendency towards empiricism, 
springing from too exclusive a reliance upon clinical 
observation, finds its natural correction only in in- 
creased familiarity with, ascertained facts respecting 
the influence of drugs upon the human system in 
health and disease ; and no argument is needed to 
show that if therapeutics is ever to attain the precision 
of a science it must be based upon the fullest attain- 
able knowledge of this kind. 

The present volume, though small in bulk, is an 
intelligent effort in this direction, containing, as it 
does, in moderate compass, such well-digested facts 
concerning the physiological and therapeutical action 
of remedies as are reasonably established up to the 
present time. By a convenient arrangement the cor- 
responding effects of each article in health and disease 
are presented in parallel columns, not only rendering 
reference easier, but also impressing the facts more 
strongly upon the mind of the reader. 

In the first American edition very considerable ad- 
ditions were found desirable to adapt it thoroughly 
to the wants of the American student — additions 



IV EDITOR S PREFACE. 

that seemed to warrant the insertion of the words 
"Materia Medica" in the title-page. Without alter- 
ing the peculiar features of the original, some changes 
were made in the arrangement, and very copious 
notes introduced, embodying the latest revision of 
the IT. S. Pharmacopoeia, together with the antidotes 
to the more prominent poisons, and such of the newer 
remedial agents as seemed necessary to the complete- 
ness of the work. All matter thus added will be 
found distinguished from the text by brackets [ ]. 

The acceptance of these modifications by the author, 
and his very conscientious revision of the whole, have 
rendered unnecessary any considerable additions by 
the editor in the present edition. He has, however, 
thought it advisable to introduce the Metric System 
in addition to the old form of writing prescriptions, 
in deference to the demands of scientific progress and 
uniformity of observation. A ready reference table 
of Poisons has been placed at the end of the book, and 
in the text itself the tests of the prominent poisons 
have been inserted. It is hoped that the additions 
that have been made to the work (which have in- 
creased its size nearly one -fourth) have more than 
proportionately enhanced its value to the student. 

In a compendious volume like the present, refer- 
ence to many authorities would be out of the ques- 
tion, but the editor must especially acknowledge his 
indebtedness to the excellent National Dispensatory 
of Drs. Stille* and Maisch, Dr. Wood's Therapeutics 
and Materia Medica, Dr. Griffith's Formulary, and the 
clinical teachings of Professor Da Costa. 

Philadelphia, April 15, 1879. 



AUTHOR'S PREFACE 



TO 



SECOND AMERICAN EDITION. 



Although I cannot but freely acknowledge that 
the gratifying success of my little book in America is 
in great measure due to the able aid of Dr. Frank 
Woodbury, and to the industry and skill with which 
he has adapted my original plan to the wants of his 
countrymen, I feel that, at least, I may share some 
part of the credit with him. That a second edition 
of a work on Therapeutics should be called for so 
rapidly in a country which has, perhaps, done more 
than any other to supply the most accurate informa- 
tion respecting the use of drugs, is of itself the best 
proof that I have not ventured rashly into print ; and 
my most earnest desire now is, to keep fully abreast 
with the progress of the day. 

Mr. Henry C. Lea, whose enterprise and liberality 
are well known and cordially appreciated in England, 
having invited me to co-operate with him in the pre- 
paration of the present edition, I have done my best 
to improve it in every respect, without materially 
adding to its bulk. Descriptions of several new drugs 
have been given, new therapeutical headings discussed 
and reference given to all recent experiments and 

A* 



vi author's preface to second edition. 

practical papers which seem to be thoroughly accepted 
by science. 

In therapeutics, as in other advancing subjects, 
much active and too frequently contradictory work 
is going on, the real stability of which time and inde- 
pendent confirmation alone will show ; and to sepa- 
rate the wheat from the chaff is one of the most 
anxious duties of the conscientious compiler. I can 
only hope that my reviewers will favor me now as 
formerly with their free and detailed criticism, by 
which I have been enabled to correct errors and 
supply omissions, and for which I tender them my 
best thanks. I have only to add, that Mr. Clover, our 
leading authority on anaesthetics, has kindly favored 
me with some notes, which will be placed within 
brackets [ — C] at the end of the various chapters 
referred to. 

23 Brook Street, Grosvenor Square, London. 

December, 1878. 



PREFACE 



TO 



FIRST EDITION. 



In these days of profuse publication, a preface 
coming from any one who ventures to write a text- 
book must assume, in great measure, an apologetic 
tone. Elaborate and comprehensive works on Thera- 
peutics now crowd our shelves, and the question may 
not unnaturally arise, What excuse can be given for 
adding another item to the rapidly increasing list ? 
In reply to this I can only express a hope that room 
may be found for a smaller handbook than those more 
elaborate treatises which reflect so faithfully the pro- 
gress of modern science, and that my little bark may 
float peacefully by the side of more richly laden ves- 
sels without being entirely submerged by their waves. 
I cannot, of course, expect either to supersede or to 
rival the classical manuals of Einger, Wood, and 
others, and all I aim at is to present the subject in 
briefer compass, in perhaps more systematic form, and 
unencumbered by any botanical or pharmaceutical 
detail. 



Vlll PREFACE TO FIRST EDITION. 

Space has not enabled me to acknowledge the 
sources from which I have been enabled to compile 
the following pages ; and I can only express in general 
terms my grateful sense of the labors of many able 
and industrious workers in the field of Therapeutics. 
I have freely drawn much valuable material from the 
systematic works of Stille", Neligan, Garrod, Ringer, 
Wood, Bartholow, Phillips, Thorowgood, Nothnagel, 
Royle, and Christison ; and I have also derived im- 
portant instruction from the writings of Brunton, 
Handfield Jones, Eraser, Fothergill, John Harley, 
Anstie, Broadbent, Liebreich, and many others who 
have contributed important aid to the progress of our 
subject in later years. 

For many of my prescriptions I am more especially 
indebted to Bartholow, and to the very handy little 
"Lessons on Prescribing" by Dr. Hansell Griffiths. 

23 Brook Street, Grosvenor Square, W. 
April j 1877. 



CONTENTS. 



introduction . . .13 
The Routes by which Medi- 
cines ENTER THE SYSTEM . 14 

External Mode of Applica- 
tion . . . .14 
(«) Epidermic method . 15 

(b) Endermic " .15 

(c) Hypodermic " .15 
(<:/) Intravenous injection 16 

Internal Administration . 16 

(«) By inhalation . . 17 

(6) By enemata . .17 

(c) By the mouth , .18 

General Rules for Pre- 
scribing . . .19 
Preliminary considera- 
tions . . . .19 
Combination of Drugs . 20 
Form of Administration . 22 



Proper time for Exhibi 

tion 
Dosage 

Interval between Doses 
Individual Peculiarities 
Idiosyncrasy ; Habit 
Constitutional or Toxic 
Effect from Small Doses 
Chemical and Physiologi- 
cal Incompatibilities 
■ Prescribing for Children . 
Prescription- writing 
Weights and Measures 
Observations upon Doses 
General rule for Doses 
General Plan of Arrange- 
ment . . . 
The Metric System in Medi- 
cine . . . . 



22 
24 
26 
26 
26 

29 

30 
33 
36 
37 

38 

;-9 

39 
43 



SECTION I. 
Remarks on certain Classes of Remedies. 



Acids . . 

Anesthetics 

Anthelmintics 

Antidotes . . . . 

Antipyretics and Refriger- 
ants .... 

Antiseptics and Disinfect- 
ants .... 

Astringents and Caustics . 

Counter-Irritants 

Diaphoretics 

Diuretics .... 



46 


Emetics .... 


63 


48 


Emmenagogues and Ecbolics 


65 


49 


Expectorants 


66 


51 


Narcotics and Anodynes 


68 




Purgatives 


70 


53 


Stimulants and Sedatives . 


73 




Tonics .... 


75 


56 


Summary of the Action of 




58 


Therapeutic Agents 


79 


59 


Clinico-Physiological Clas- 




60 


sification of Drugs 


80 


61 







CONTENTS. 



SECTION II. 



Remedies comprised in the Primary List of the United States 
Pharmacopoeia and their Preparations. 



Those preparations marked * are not officinal. 



Absinthium 

Acacia .... 

Syrupus Acaciae 

Mucilago Acacia? 
Acetum .... 

Acetum Destillatum 
Acidum Aceticum 

Acidum Aceticum Dilutum 
Aceta .... 
Acidum Arseniosum 
Acidum Carboltcum Impur. . 
Acidum Carbolicum . 

Glyceritum Acidi Carbolici 

Unguent. Acidi Carbolici 

Supposit. Acidi Carbolici 

Aqua Acidi Carbolici 
Acidum Chromicum 
Acidum Citricum 

Syrupus Acidi Citrici 
Acid.Gallicum (seeGALLA). 
Acid. Hydrocyanigum Dil. . 

Potassii Cyanidum . 

Ferri Ferrocyanidum 

Potassii Ferrocyanidum . 
Acidum Lacticum 

Ferri Lactas 
Acidum Muriaticum . 

Acid. Muriat. Dilut. 
Acidum Nitricum 

Acidum Nitricum Dilut. . 
Acidum Nitro-Muriaticum . 

Acid.Nitro-Muriat. Dilut. 
Acidum Oxalicum 

Ferri Ox alas . 
Acid. Phosphoric. Glaciale 

Acid. Phosphor. Dilut. . 
Acidum Sulphuricum . 

Acid, Sulphuric, Aromat. 

Acid. Sulphuric. Dilut. . 
Acidum Sulphurosum . 
Acidum Tannicum 

Unguent. Acidi Tannici . 

Glyceritum Acidi Tannici 

Suppositoria Acidi Tannici 



81 


Trochisci Acidi Tannici . 103 


81 


Acidum Tartaricum 


. 103 


81 


Ferri et Ammonii Tartras 103 


81 


Pulveres Effervescentes . 103 


82 


Pulv. Efferv. Aperientes . 103 


82 


Acidum Valerianicum 


. 104 


82 


Ammonii Valerianae 


. 104 


82 


Quiniae Valerianas 


. 104 


84 


Zinci Valerianas 


. 104 


84 


Acida 


. 105 


84 


ACONITUM . 


. .105 


84 


Aconiti Folia . 


. 105 


84 


Aconiti Radix . 


. 105 


84 


Aconitia . 


. 105 


84 


Extr actum Aconiti 


. 105 


84 


Emplastrum Aconiti . 105 


88 


Linimentum Aconiti 


. 105 


88 


Tinctura Aconiti Radicis 105 


88 


Adeps . 


. 110 




Ceratum . 


. 110 


89 


Unguentum 


. no 


90 


iEl'HER 


. no 


90 


iEther Fortior . 


. in 


90 


Spiritus vEtheris Comp. . Ill 


94 


iEtherea . 


. 114 


94 


Alcohol 


. 114 


95 


Alcohol Dilutum 


. 114 


95 


Alcohol Fortius 


. 114 


97 


Vinum Xericum 


. 114 


97 


Vinum Portense 


. 114 


98 


Spiritus Vini Gallic 


L . 114 


98 


Spiritus Frumenti 


. 114 


98 


Spiritus Myrciae 


. 114 


98 


Spiritus iEtheris Compos. 121 


99 


Spiritus iEtheris Nitrosi . 122 


99 


Alcohol Amylicum 


. 122 


loo 


Allium 


. 122 


100 


Syrupus Allii . 


. 122 


100 


Aloe . 


. 123 


102 


Aloe Barbadensis 


. 123 


103 


Aloe Capensis . 


. 123 


103 


Aloe Socotrina 


. 123 


103 


Aloe Purificata 


. 123 


103 


Pilulae Aloes . 


. 123 



CONTENTS. 



XI 



Pil. Aloes et Assafoetidse . 123 
Pilulse Aloes et Mastiches 123 
Pilulse Aloes et Myrrhse . 123 
Pilulse Rhei Compositse . 123 
Pulvis Aloes et Canellae . 123 
Tinctura Aloes . . 123 

Tinctura Aloes et Myrrh ae 123 
Tinct. Benzoini Composita 123 
Vinuui Aloes . . . 124 
Suppositoria Aloes . . 124 
Alth;ba .... 125 
Alumen .... 125 
Alumen Exsiceatum . 125 

Aluminii et Potass. Sulphas 127 
Aluminii Sulphas . . 127 
Ammoniacum . . . 127 
Mistura Aramoniaci . 127 

Pilulae Scillae Compositse . 127 
Emplastrum Ammoniaci . 127 
Emp. Am. cum Hydrarg. 127 
Ammonium .... 127 
Aqua Ammoniae Fortior . 127 
Aqua Animonise . . 128 

Linimentum Ammoniae . 128 
Liquor Ammonii Acetatis 128 
Spiritus Ammoniae . . 128 
Spirit. Amnion. Aromat. . 128 
Tinct. Gruaiaci Ammoniata 128 
Tinct. Valerianae Amnion. 128 
Alumen . . . .128 
Ammonii Benzoas . . 128 
Ammonii Bromiduni . 128 

Ammonii Carbon as . .128 
Ammonii Chloridum . 128 

Ammon. Chi or. Purificat. 128 
Ammonii Iodidum . .128 
Ammonii Nitras . . 128 
Ammonii Sulphas . . 128 
Ammonii Valerianas . 128 
Cuprum Ammoniatum . 128 
Ferri et Ammonii Citras . 128 
Ferri et Ammonii Sulphas 128 
Ferri et Ammonii Tartras 128 
Hydrarg. Ammoniatum . 128 
Amygdalus . 133 

Amygdala Amara . . 133 
Amygdala Dulcis . . 133 
Mistura Amygdalae . . 133 
Oleum Amygdalae Amarae 133 
01. Amygdalae Expressum 133 
Aqua Amygdalae Amarae . 133 
Syrupus Amygdalae . 134 



Unguentum Aquae Rosae . 134 

Amylum .... 134 

Angustura .... 134 
Infusum Angusturae . 134 

Anisum .... 135 
Aqua Anisi . . . 135 
Oleum Anisi . . . 135 

Spiritus Anisi . . .135 

Anthemis .... 135 
Infusum Anthemidis . 135 

Antimonium . . . 135 

Antimonii Sulphuretum . 135 
Antimonii Oxidum . . 135 
Antimonii et Pot. Tartras 135 
Antimonium Sulphurat. . 136 
Antimonii Oxysulphuret. 136 
Pil. Antimonii Compositae. 136 
Vinum Antimonii . . 136 
Emplastrum Antimonii . 136 
Unguentum Antimonii . 136 
Syr. Scillae Compositus . 136 

Aqua 141 

Aqua Destillata . . 141 

Aquas .... 146 

Argentum .... 146 
Argenti Cyanidum . . 146 
Argenti Nitras . . 146 

Argenti Nitras Fusa . 146 

Argenti Oxidum . . 146 

Arnica .... 148 

Extractum Arnicse . . 148 
Emplastrum Arnicse . 148 

Tinctura Arnicse . . 148 

Arsenicum .... 149 
Acidum Arseniosum . 149 

Arsenici Iodidum . . 149 
Liq. Arsen. et Hyd. Iod. . 149 
Liquor Arsenici Chloridi 149 
Liquor Potassii Arsenitis 149 
Sodii Arsenias . . . 149 
Liquor Sodii Arseniatis . 149 

ASSAFQ3TIDA . . . 155 

Mistura Assafoetidae . 155 

Tinctura Assafoetidae . 155 

Pilulae Assafoetidae . . 156 

Pil. Aloes et Assafoetidae . 156 

Suppositoria Assafoetidae . 156 

Emplastrum Assafoetidae . 156 

Pilulae Oalbani Compositse 156 

Aurantium . . . . 156 

Aurantii Amari Cortex . 156 

Aurantii Dulcis Cortex . 156 



Xll 



CONTENTS. 



Aurantii Flores . .156 
Aqua Aurantii Florum . 157 
Syrupus Aurantii Florum 157 
Confect. Aurantii Corticis 157 
Syrupus Aurantii Corticis 157 
Tinctura Aurantii . .157 
Infusum Gentianas Comp . 157 
Tinctura Gentianas Comp . 157 
Tinctura Cinchonas Comp. 157 



Avenge Farina 


157 


Balsamum Peruvianum 


158 


Balsamum Tolutanum . 


158 


Syrupus Tolutanus . 


158 


Tinctura Tolutana . 


158 


Tinctura Benzonii Comp . 


158 


Barii Carbonas . 


158 


Barii Cliloridum 


158 


Liquor Barii Chloridi 


158 


Belladonna 


159 


Belladonnse Folia 


159 


Belladonna? Radix . 


159 


Tinctura Belladonnse 


159 


Extractum Belladonnas . 


159 


Ext. Belladonnas Alcoholic 


159 


Ext. Bellad. Radicis Fluid 


159 


Emplastrum Belladonnas . 


159 


Unguentum Belladonnas . 


159 


Suppositoria Belladonnas 


159 


Atropia . 


159 


Atropias Sulphas 


159 


Benzoinum . 


168 


Acidum Benzoicum . 


168 


Ammonii Benzoas . 


168 


Tinctura Benzoini . 


168 


Tinct. Benzoini Composita 


168 


Unguentum Benzoini 


168 


Oleum Bergamii . 


169 


Bismuthum . 


169 


Bismuthi Subcarbonas 


169 


Bismuthi Subnitras 


169 


Brominium . . . . 


170 


Ammonii Bromidum 


170 


Potassii Bromidum . 


170 


Buchu . . . . 


171 


Ext. Buchu Fluidum 


171 


Infusum Buchu 


171 


Cadmium . 


172 


Cadmii Sulphas 


172 


Caffea . 


172 


Cajuputi . 


173 


Calcium .... 


173 


Calcii Chloridum 


173 



Calcii Hypophosphis . 173 
Calx . . . .173 

Calx Chlorinata . . 173 
Calcis Hydras . . . 173 
Calcii Carbon. Prascipitata 173 
Calcii Phosph. Prascipitata 173 
Creta . . . .173 
Creta Prasparata . .173 
Hydrargyrum cum Creta . 173 
Trochisci Cretas . .173 
Mistura Cretas . . ,. 173 
Testa Prasparata . . 173 
Liquor Calcii Chloridi . 173 
Liquor Calcis . . . 173 
Linimentum Calcis . .173 
Potassa cum Calce . . 173 

Calumba .... 175 
Ext. Calumbas Fluidum . 175 
Infusum Calumbas . .175 
Tinctura Calumbas . .175 

Camphora . . . .176 
Oleum Camphoras . . 176 
Aqua Camphoras . . 176 
Linimentum Camphoras . 176 
Linimentum Saponis . 177 
Mistura Chloroformi . 177 

Cerat. Plumbi Subacetatis 177 
Spiritus Camphoras . .177 
Tinctura Opii Camphorata 177 

Canella .... 179 
Pulvis Aloes et Canellas . 179 
Vinum Rhei . . .179 

Canna . . . .179 

Cannabis Americana . . 179 
Ext. Cannabis Americanas 179 

Cannabis Indica . . .179 
Extract. Cannabis Indicas 179 
Tinctura Cannabis . 179 

Cantharis .... 181 
Tinctura Cantharidis . 181 
Ceratum Cantharidis . 181 
Ceratum Ext. Cantharide 181 
Charta Cantharidis . . 181 
Collod. cum Cantharide . 181 
Linimentum Cantharidis . 181 
Emp. Picis cum.Canth. . 181 
Unguentum Cantharidis . 181 

Chartae . . . .185 

Capsicum . . . . 185 
Infusum Capsici . . 185 
Oleo-resina Capsici . . 185 
Tinctura Capsici . . 185 



CONTENTS 



Xlll 



Carbo .... 

Carbo Animalis . 

Carbo Animalis Purificat. 
Carbo Ligni 
Cardamomum 

Ext. Colocynthidis Comp. 

Pulvis Aromaticus . 

Tinctura Cardamomi 

Tinct. Cardamomi Comp. 

Tinct. Gentianse Comp. 

Tinctura Rliei . 

Vinum Aloes . 

Confectio Aromatica 
Carum 

Oleum Cari 

Tinct. Cardamomi Comp. 
Caryophyllus 

Infusum Caryophyll 

Oleum Caryophylli 
Cascarilla 

Infusum Cascarillae 
Cassia Fistula . 
Cassia Marilandica 
Castoreum . 

Tinctura Castorei 
Cataria 
Catechu 

Infusum Catechu Comp. 

Tinctura Catechu 
Cerata 
Cera Flava 
Cera Alba . 
Cerium 

Cerii Oxalas . 
Cetaceum . 

Ceratum Cetacei 

Unguentum Aquse Rosse 
Cetraria 

Decoctum Cetrarise 
Chenopodium 

Oleum Chenopodii 
Chimaphila 

Decoctum Chimaphilse 

Extract. Chima. Fluidum 
Chiretta 
Chloral 

Croton-Chloral* 
Chlorinum 

Aqua Chlorini . 
Chloroformum . 

Chloroformum Venale 

Chloroform. Purificatum 
B 



185 

185 

185 

185 

185 

187 

187 

187 

188 

188 

188 

188 

188 

188 

188 

188 

188 

188 

188 

189 

189 

189 

189 

189 

189 

190 

190 

190 

190 

190 

191 

191 

191' 

191 

191 

191 

191 

192 

192 

192 

192 ! 

192 

192 

192 

193 

193 

199 

201 

201 

202 

202 

202 



Mistura Chloroformi . 202 

Spiritus Chloroformi . 202 
Linimentum Chloroformi 202 
Chondrus .... 210 
Cimicifuoa .... 210 
Extract. Chnicifugse Flu. 210 
Cinchona .... 210 
Cinchona Flava . . 210 
Cinchona Pallida . . 210 
Cinchona Rubra . . 211 
Cinchonise Sulphas . . 211 
Decoctum Cinchonse Flavse 211 
Extract lira Cinchonse . 211 
Extractum Cinchonse Flu. 211 
Infusum Cinchonas Flavse 211 
Quinise Sulphas . . 211 
Pilulse Quinise Sulphatis 211 
Tinctura Cinch onae . . 211 
Decoct. Cinchonse Rubrse . 211 
Infusum Cinchonse Rubrse 211 
Tinct. Cinchonse Comp. . 211 

ClNNAMOMUM . . . 221 

Oleum Cinnamomi . . 221 

Tinctura Cinnamomi . 221 

Aqua Cinnamomi . . 221 

Pulvis Aromaticus . . 221 

Confectio Aromatica . 221 

Spiritus Cinnamomi . 221 

Coccus .... 222 

Colchicum .... 222 

Colchici Radix . . 222 

Colchici Semen . . 222 

Extract. Colch. Acetic urn 222 

Ext. Colch. Radicis Fluid. 222 

Vinum Colchici Radicis . 222 

Ext. Colch. Seminis Fluid. 222 

Tinctura Colchici . . 222 

Vinum Colchici Seminis . 222 

COLOCYNTHIS .... 224 

Extractum Colocynthidis. 224 

Ext. Colocynthidis Comp. 224 

Pilulse Catharticse Comp. 224 

Confectiones . . . 225 

Conium .... 225 

Conii Folia . . .225 

Conii Fructus . . . 225 

Ext. Conii Fructus Fluid. 225 

Extractum Conii . . 225 

Ext. Conii Alcoholicum . 225 

Succus Conii . . . 225 

Tinctura Conii . . 226 

Copaiba . . . .229 



XIV 



CONTENTS. 



Oleum Copaiba? . . 229 

Pilula? Copaiba? . . 229 

Coptis . . . .232 

coriandrum . . . 232 

Cornus Florida . . . 232 

Decoctum Cornus Florida? 232 

Ext. Corn. Floridse Fluid. 232 

Creasotum . . . . 233 

Aqua Creasoti . . . 233 

Unguentum Creasoti . 233 

Creta .... 233 

Crocus .... 233 

Cubeba .... 233 

Extractum Cubeba? Fluid. 233 

Oleo-Resina Cubeba? . 233 

Oleum Cubebse . . 234 

Tinctura Cubeba? . . 234 

Trochisci Cubeba? . . 234 

Cuprum .... 234 

Cupri Subacetas . . 234 

Cupri Sulphas . . 234 

Cuprum Ammoniatum . 234 

Decocta .... 237 

Digitalis .... 237 

Digital inum . . . 237 

Extractum Digitalis . 237 

Ext. Digitalis Fluidum . 237 

Infusum Digitalis . . 237 

Tinctura Digitalis . . 237 

Dulcamara . . . 243 

Decoctum Dulcamara? . 243 

Extractum Dulcamara? . 243 

Ext. Dulcamara? Fluidum 243 

Elaterium . . . ■ . 244 

Emplastra . . . 245 

Ergota .... 245 

Ext. Ergota? Fluidum . 245 

Vinum Ergota? . . 245 

Ergotine* . . . 245 

Erigeron .... 249 

Erigeron Canadense . . 249 

Ext. Eriger. Can. Fluid. . 249 

Oleum Eriger. Canadensis 249 

Eupatorium . . . 249 

Infusum Eupatorii . . 249 

Extracta . . . . 250 

Fermektum . . . 250 

Ferrum .... 251 

Ferri Hypophosphis . 251 

Ferri Sulphuretum . . 251 

Ferri Chloridum . . 251 

Liquor Ferri Chloridi . 251 



Tinctura Ferri Chloridi . 251 
Ferri Citras . . .251 
Liquor Ferri Citratis . 251 
Ferri et Ammonii Citras . 251 
Ferri et Ammonii Sulphas 251 
Ferri et Ammonii Tartras 251 
Ferri et Potassii Tartras . 251 
Ferri et Quinia? Citras . 251 
Ferri et Strychnia? Citras 251 
Ferri Ferrocyanidum . 251 
Ferri Lactas . . . 251 
Ferri Oxalas . . . 251 
Ferri Oxidum Hydratuni 251 
Ferri Phosphas . . 251 
Ferri Pyrophosphas . 252 

Ferri Subcarbonas . . 252 
Emplastrum Ferri . . 252 
Trochisci Ferri Subcarb. . 252 
Ferri Sulphas . . .252 
Mistura Ferri Composita . 252 
Ferri Sulphas Exsiccata . 252 
Ferrum Redactum . . 252 
Pilula Ferri Carbonatis . 252 
Pilula? Ferri Composita? . 252 
Pilula? Ferri Iodidi . . 252 
Syrupus Ferri Iodidi . 252 
Liquor Ferri Nitratis . 252 
Liquor Ferri Subsulphatis 252 
Liquor Ferri Tersulphatis 252 
Potassii Ferrocyanidum . 252 

Ficus 257 

FilixMas . . . .257 
Oleo-resina Filicis . . 257 

Fceniculum .... 258 
Oleum Fceniculi . . 258 
Aqua Fceniculi . . 258 

Galbanum .... 259 
Emp. Galbani Compos. . 259 
Pilulae Gralbani Composita? 259 

Galla . . . .259 

Acidum Gfallicum . . 259 
Tinctura Galla? . . 259 
Unguentum Galla? . . 259 
Glyceritum Acidi Gallici . 259 
Acidum Tannicum . . 259 
Unguentum Acidi Tannici 259 
Glyceritum Acidi Tannici 259 
Suppositoria Acidi Tannici 259 
Trochisci Acidi Tannici . 259 

Gambogia .... 260 

Gaultheria . . . 262 

Oleum Gaultheria? . . 262 



CONTENTS. 



XV 



GeLSEMIUM .... 262 

Ext. Gelsemii Fluidum . 262 

Gentiana. .... 264 

Extractum Gentianae . 264 

Ext. Gentianae Fluidum . 264 

Infusum Gentianae Comp. 264 

Tinct. Gentianae Comp. . 264 

Geranium .... 265 

Extractum Geranii Fluid. 265 

Glycerina .... 265 

Glycerita. . . .266 

Glycyrrhiza . . . 266 

Ext. Glycyrrliizae Fluid. . 266 

Ext. Glycyrrliizae . 266 

Mistura Glycyrr. Comp. . 266 

Troch. Glycyrr. et Opii . 266 

Gossypii Radicis Cortex . 267 

Ext. Gossypii Rad. Fluid. 267 

Gossypium .... 267 

Pyroxylon . . . 267 

Collodium . . .267 

Collodium cum Canthar. 268 

Collodium Flexile . . 268 

Guaiacum .... 269 

Guaiaci Lignum . . 269 

Guaiaci Resinae . . 269 

Tinctura Guaiaci . . 269 

Tinct. Guaiaci Ammoniata 269 

Gutta-Percha . . . 269 

Liquor Gatta-Percliae . 269 

HiEMATOXYLON . . . 270 

Decoctum Hsematoxyli . 270 

Extractum Haematoxyli . 270 

Hedeoma .... 270 

Oleum Hedeomae . . 270 

Helleborus . . . 271 

Extractum Hellebori . 271 

Tinctura Hellebori . . 271 

HORDEUM .... 271 

Decoctum Hordei . . 271 

Humulus .... 271 

Infusum Humuli . . 271 

Tinctura Humuli . . 271 

Lupulina . . . 271 

Ext. Lupulinae Fluidum . 271 

Oleo-Res-ina Lupulinae . 271 

Tinctura Lupulinae . . 272 

Hydrargyrum . . . 272 

Emp. Ammon. cum Hydr. 272 

Emplastrum Hydrargyri 272 

Hydrargyrum cum Creta 272 

Pilulae Hydrargyri . . 272 



(Jnguentum Hydrargyri . 272 
Hydrarg. Oxid. Rubrum . 272 
Ung. Hydr. Oxidi Rubri . 272 
Hydrarg. Oxidum Flav. . 272 
Ung. Hydr. Oxidi Flavi . 272 
Hydr. Sulph. Rubrum . 272 
Hydr. Chloridum Mite . 272 
Pil. Antimonii Comp. . 272 
Pil. Cathartics Comp. . 272 
Hydr. Chlor. Corrosivum 272 
Hydrarg. Ammoniatum . 273 
Ung. Hydr. Ammoniata . 273 
Hydr. Iodidum Rubrum . 273 
Ung. Hydr. Iodidi Rubri . 273 
Liquor Arsenici et Hydrar- 
gyri Iodidi. . . . 273 v 
Hydrarg. Iodidum Viride 273 
Hydrargyri Cyanidum . 273 
Liquor Hydrarg. Nitratis 273 
Ung. Hydrarg. Nitratis . 273 
Hydrargyri Sulphas Flava 273 
Hydrastis .... 273 
Extract. Hydrastis Fluid. 273 
Hyoscyamus . . . 284 

Hyoscyami Folia . . 284 
Hyoscyami Semen . . 284 
Extractum Hyoscyami . 284 
Ext. Hyoscy. Alcoholicum 284 
Ext. Hyoscyami Fluidum 284 
Tinctura Hyoscyami . 284 
ichtiiyocolla . . . 286 
Ignatia . . . .286 
Extractum Ignatiae . . 286 
Infusa . . . .286 
Iodixtum .... 287 
Tinctura Iodinii . . 287 
Tinctura Iodinii Composita 287 
Liquor Iodinii Compositus 287 
Unguentum Iodinii . . 287 
Ung. Iodinii Compositum 287 
Liq. Arsen. et Hydrar. Iod. 287 
Syrupus Ferri Iodidi . 287 
Piluhe Ferri Iodidi . .287 
iodoformum . . . 289 

Ipecacuanha . . . 289 
Ext. Ipecacuanhae Fluid. 289 
Pulvis Ipecacuanhae Comp. 289 
Trochisci Ipecacuanhae . 289 
Troch. Morph. et Ipecac. . 289 
Syrupus Ipecacuanhae . 289 
Vinuin Ipecacuanhae . 289 
Jalapa .... 294 



XVI 



CONTENTS. 



Extractum Jalapae . . 294 
Pulvis Jalapae Compositus 294 
Resin a Jalapae . . 294 

Tinctura Jalapae . . 294 

Juglans . . . .295 
Extractum Juglandis . 295 

Junipekus .... 295 
Infusum Juniperi . .295 
Oleum Juniperi . . 295 

Spiritus Juniperi . . 295 

Spiritus Juniperi Compos. 295 

Kino ..... 296 
Tinctura Kino . . .296 

Krameeia .... 297 
Extractum Krameriae . 297 
, Ext. Krameriae Fluidum . 297 
Infusum Kramerise . .297 
Syrupus Krameriae . . 297 

Tinctura Kramerise . .297 

Lactucarium . . . 297 
Syrupus Lactucarii . .297 

Lavandula .... 298 
Oleum Lavandulae . . 298 
Spiritus Lavandulae . 298 

Spiritus Lavandulae Comp. 298 

Leptandra . . . .298 

Limones . . . .298 
Limonis Cortex . . 298 
Limonis Succus . . 298 

Oleum Limonis . . 298 

Spiritus Limonis . . 298 

Syrupus Limonis . . 298 
Acidum Citricum . . 298 
Mistura Potassii Citratis . 298 
Spiritus Ammoniae Arom. 298 
Syrupus Acidi Citrici . 298 

Linimenta . . . 300 

Linum .... 300 

Oleum Lini . . .300 
Lini Farina . . . 300 
Infusum Lini Compos itum 300 
Linimentum Calcis . . 300 

Lithium .... 301 
Lithii Carbonas . . 301 
Lithii Citras . . .301 

Lobelia . 302 

Acetum Lobeliae . . 302 
Tinctura Lobeliae . . 302 

Liquores .... 304 

Lycopodium . . . 304 

Magnesium .... 304 
Magnesii Carbonas . . 304 



Magnesii Sulphas . . 304 

Magnesia . . . 304 

Trochisci Magnesiae . . 304 

Liquor Magnesiae Citratis 304 

Manganesium . . . 306 

Manganesii Oxid. Nigrum 306 

Manganesii Sulphas . 306 

Manna .... 306 

Maranta .... 307 

Marmor .... 307 

Marrubium .... 307 

Mastiche .... 307 

Pilulae Aloes et Mastiches 307 

Matico . . . .307 

Extractum Matico Fluidum 307 

Matricaria . . . 308 

Mel 308 

Mel Despumatum . . 308 

Mellita . . . .308 

Mentha Piperita . . 309 

Aqua Menthae Piperitae . 309 

Oleum Menthae Piperitae . 309 

Spiritus Menthae Piperitae 309 

Trochisci Menthae Piperitae 309 

Mentha Viridis . . . 309 

Aqua Menthae Viridis . 309 

Oleum Menthae Viridis . 309 

Spiritus Menthae Viridis . 309 

Mezereum .... 309 

Extractum Mezerei Fluid. 309 

Unguent urn Mezerei . 309 

Decoct. Sarsaparillae Comp. 309 

Ext. Sarsap. Comp. Fluid. 309 

Misturge . . . 310 

Monarda .... 310 

Oleum Monardae . . 310 

Moschus . . . .310 

Mucilagines . . . 310 

Myristica .... 311 

Spiritus Myristicee . . 311 

Oleum Myristicae . .311 

Macis . . . . . 311 

Myrriia .... 311 

Tinctura Myrrhae . .311 

Tinctura Aloes et Myrrhae 311 

Pilulae Aloes et Myrrhae . 311 

Ne,ctandra . . . .313 

Nux Vomica . . . 313 

Tinctura Nucis Vomicae . 313 

Extractum Nucis Vomicae 313 

Strychnia . . . 313 

Strychniae Sulphas . . 313 



CONTENTS. 



XVll 



Olea . . . . .317 
Oleum ^Ethereum . .317 
Oleum Morrhu^ . . . 317 
Oleum Oliv^: . . . 321 
Oleum Ricini . . . 321 
Oleum Succmi . . . 322 
Oleum Succini Rectificatum 322 
Oleum TuEOBROMiE . . 323 
Oleum Thymi ~ . . 323 

Oleum Tiglii . . .323 

Opium 325 

Acetum Opii . . . 325 
Confectio Opii . . .325 
Extractum Opii . . 325 
Emplastrum Opii . . 325 
Suppositoria Opii . . 325 
Suppositoria Plumbi et Opii 325 
Pilulae Opii . . .325 
Pilula Saponis Composita 325 
Pulvis Ipecac. Compositus 325 
Tinctura Opii . . .325 
Tinctura Opii Acetata . 325 
Tinctura Opii Camphorata 325 
Tinctura Opii Deodorata . 326 
Trochisci Glycyr. et Opii . 326 
TrochisciMorph. et Ipecac. 326 
Liquor Morphia? Sulphatis 326 
Suppositoria Morphiae . 326 
Vinum Opii . . .326 
Morphia . . . .326 
Morphiae Acetas . .326 
Morphiae Murias . . 326 
Morphias Sulphas . . 326 
Origanum . . . . 335 
Oleum Origani . . 335 

Os 336 

Ovum 336 

Papaver .... 336 

Pareira .... 336 

Ext. Pareirae Fluidum . 336 

Infusum Pareirae . .336 

Pepo 337 

Phosphorus . . . 337 

Physostigma . . . 341 
Extractum Physostigmatis 341 
Pilulae . . . .344 
Pimenta . . . . 344 
Oleum Pimentae . . 344 

Piper 345 

Oleo-resina Piperis . . 345 

Pix Burgundica . . . 345 

Emp. Picis Burgundica . 345 



Pix Canadensis . . . 345 
Emp. Picis Canadencis . 345 

Pix Liquida . . . 346 

Glyceritum Picis Liquidae 346 
Infusum Picis Liquidae . 346 
Unguentum Picis Liquidae 346 

Plumbum .... 347 
Plumbi Oxidum . . 347 
Emplastrum Plumbi . 347 
Liquor Plumbi Subacetatis 347 
Liq. Plumbi Subacet. Dil. 347 
Ceratum Plumbi Subacet. 347 
Liq. Plumbi Subacetatis . 347 
Plumbi Acetas . . 347 

Suppositoria Plumbi . 347 

Suppositoria Plumbi et Opii 347 
Plumbi Carbonas . . 347 
Ung. Plumbi Carbonatis . 3-17 
Plumbi Nitras . . 347 

Plumbi Iodidum . . 347 
Unguentum Plumbi Iodidi 347 

Podophyllum . . .351 
Extractum Podophylli . 351 
Resina Podophylli . . 351 

Potassium .... 352 
Potassa .... 352 
Liquor Potassae . . 352 

Potassa cum Calce . . 352 
Potassii Acetas . . 352 

Potassii Bitartras . . 352 
Antimonii et Potassii Tart. 353 
Ferri et Potassii Tart. . 353 
Pulvis Jalapae Compositus 353 
Potassii Carbonas Impura 353 
Potassii Carbonas . . 353 
Potassii Carbonas Pura . 353 
Potassii Bicarbonas . . 353 
Liquor Potassii Arsenitis . 353 
Potassii Chloras . . 353 
Trochisci Potas. Chloratis 353 
Potassii Citras . . 353 

Liquor Potassii Citratis . 353 
Mistura Potassii Citratis . 353 
Potassii Cyanidum . . 353 
Potassii Ferrocyanidum . 353 
Potassii Hypophosphis . 353 
Ung. Potassii Iodidi . 353 

Potassii Nitras . . 353 

Potassii Permanganas . 353 
Liquor Potassii Permang. 353 
Potassii Sulphas . . 353 
Pulvis Ipecacuanha? Comp. 353 



XV111 



CONTENTS 



Potassii Sulphis . . 353 

Potassii Sulphuretum . 354 

Potassii et Sodii Tartras . 354 

Potassii Tartras . . 354 

Potassii Bicliromas . . 359 

Potassii Bromidum . . 360 

Potassii Iodidum . . 364 

Prunum . ". . . 369 

Prunus Virginian a . . 369 

Ext. Pruni Virgin. Fluid. 369 

Infusum Pruni Virginianas 369 

Syrupus Pruni Virginianas 369 

Pulveres . . . .369 

Punica GRANATUM . . 370 

Granati Fructus Cortex . 370 

Granati Radicis Cortex . 370 

Quassia .... 370 

Extractum Quassise . . 370 

Infusum Quassise . . 370 

Tinctura Quassias . . 370 

Quercus Alba . . . 371 

Decoctum Quercus Albas . 371 

QuEBCUS TlNCTORIA . . 371 

Resina .... 371 

Ceratnm Resinas . . 371 

Ceratum Resinas Comp. . 371 

Emplastrum Resinas . 371 

Resinae .... 371 

Oleo-Resinae . . . 371 

Riieum .... 372 

Extractum Rhei . .372 

Extractum Rhei Fluidum 372 

Infusum Rhei . . . 372 

Pilulas Rhei . . .372 

Pilulas Rhei Compositas . 372 

Pulvis Rhei Compositus . 372 

Syrupus Rhei . . .372 

Syrupus Rhei Aromaticus 372 

Tinctura Rhei . . . 372 

Tinct. Rhei et Sennas . 372 

Vinum Rhei . . .372 

Rosa Cbntifolia . . . 373 

Rosa Gallica . . . 373 

Oleum Rosas . . . 373 

Aqua Rosas . . . 374 

Confectio Rosas . . 374 

Infusum Rosas Comp. . 374 

Mel Rosas . . .374 

Syrupus Rosas Gallicas . 374 

Uuguentum Aquas Rosas . 374 

Rosmarinus . . . 374 

Oleum Rosmarini . . 374 



Rubus ..... 

Extractum Rubi Fluidum 

Syrupus Rubi . 
Ruta . 

Oleum Rutas 
Sabadilla . 

Veratria . 

Unguentum Veratrias 
Sabina .... 

Ceratum Sabinas 

Extractum Sabinas Fluid. 

Oleum Sabinas . 
Sacciiarum .... 

Syrupus . . . . 

Syrupus Fuscus 
Saccharum Lactis 
Sago ..... 
Salvia 

Infusum Salvias 
Sambucus . . . . 
Sanguinaria 

Acetum Sanguinarias 

Tinctura Sanguinarias 
Santalum .... 
Santonica .... 

Santoninum 

Trochisci Santonin! . 
Sapo . . . 

Ceratum Saponis 

Emplastrum Saponis 

Linimentum Saponis 

Pilula Saponis Composita 
Sarsaparilla 

Decoct. Sarsaparillas Comp. 

E.\tr. Sarsaparillas Fluid. 

Ext. Sarsap. Comp. Fluid. 

Syrupus Sarsap. Comp. 
Sassafras .... 

Oleum Sassafras 

Sassafras Medulla . 

Mucilago Sassafras Medul. 
Scammonium 

Resina Scammonii . 

Ext. Colocynthidis Comp. 
Scilla .... 

Acteum Scillas . 

Syrupus Scillas 

Pilulas Scillas Compositas . 

Syrupus Scillas Compositus 

Tinctura Scillas 

Extractum Scillas Fluidum 
Scoparius .... 



374 
374 

374 
375 
375 
375 
375 
375 
377 
377 
377 
377 
377 
377 
377 
378 
378 
378 
378 
378 
379 
379 
379 
379 
379 
379 
379 
382 
382 
382 
382 
382 
383 
383 
383 
383 
383 
384 
384 
384 
384 
384 
384 
384 
385 
385 
385 
385 
385 
385 
385 
386 



CONTENTS. 



XIX 



Senega .... 387 
Decoctum Senega? . . 387 
Extractum Senegae . . 387 

Extractum Senega? Fluid. 387 
Syrupus Senegse . . 387 
Senna . . . .388 

Confectio Senna? . . 388 
Extractum Senna? Fluidum 388 
Infusum Senna? . . 389 
Tinctura Rhei et Senna? . 389 
Serpentaria . . . 389 
Ext, Serpentaria? Fluidum 389 
Infusum Serpentaria? . 389 
Tinctura Serpentaria? . 390 
Sevum . . . .390 

Sinapis Alba . . . 390 
Sinapis Nigra . . . 390 
Charta Sinapis . . 390 

Sodium .... 392 

Sodii Acetas . . . 392 
Sodii Bicarbonas Venalis . 392 
Sodii Boras . . .392 
Grlyceritum Sodii Boratis . 392 
Mel Sodii Boratis . . 392 
Sodii Carbonas . . 392 

Sodii Chloridum . . 392 
Sodii Hypophosphis . 392 

Sodii Hyposulphis . . 392 
Sodii Nitras . . .392 
Sodii Sulphas . . .392 
Sodii Sulphis . . .392 
Soda . . . .392 

Liquor Soda? . . . 392 
Sodii Arsenias . . . 392 
Liquor Sodii Arseniatis . 392 
Sodii Bicarbonas . . 393 
Trochisci Sodii Bicarb. . 393 
Sodii Carbonas Exsiccata 393 
Sodii Phosphas . . 393 

Liquor Soda? Chlorinata? . 393 
Spigelia . . . .395 
Extract. Spigelia? Fluidum 395 
Extractum Spigelia? et 

Senna? Fluidum . 395 

Infusum Spigelia? . .395 

Spiritus .... 395 
Spiritus Frumenti . . 395 
Spiritus Myrcle . . 395 

Spiritus Vini Gallici . .396 
Statice .... 396 
Stillingia . . . .396 
Extr. Stillingia? Fluidum 396 



Stramonium . . .396 

Stramonii Folia . .396 

Stramomi Semen . . 396 

Extr. Stramonii Foliorum 397 

Extr. Stramonii Seminis . 397 

Tinctura Stramonii . . 397 

Uiiguentum Stramonii . 397 

Styrax . . . .397 

Succi . . . .397 

Sulphur . . . .397 

Sulphur Lotum . .397 

Sulphur Sublimatum . 397 

Sulphur Pra?cipitatum . 398 

Snlphuris Iodidum . . 398 

Unguentum Sulphuris . 398 

Ung. Sulph. Iodidi . . 398 

Sodii Hyposulphis . . 398 

Sodii Sulphis . . .398 

Potassii Sulphis . . 398 

Suppositoria . . . 400 

Syrupi .... 400 

Tabacum . . . .400 

Infusum Tabaci . . 400 

Oleum Tabaci . . . 400 

Unguentum Tabaci . . 400 

Viiiam Tabaci . . 400 

Tamarindus . . . 403 

Tapioca . . . .403 

Taraxacum . . . 403 

Extractum Taraxaci . 403 

Ext. Taraxaci Fluidum . 403 

Infusum Taraxaci . . 403 

Succus Taraxaci . * . 403 

Terebinthina . . . 404 

Terebinthina Canadensis . 404 

Oleum Terebintbina? . 404 

Linimentum Terebinthina? 404 

Testa 404 

Testa Pra?parata . . 407 

Tincturae . . . 407 

Tragacantha . . . 408 

Mucilago Tragacantha? . 408 

Trochisci . . . . 408 

Ulmus .... 408 

Mucilago Ulmi . . 408 

Unguenta . . . 409 

Uva Passa . . . .409 

UvaUrsi . . . .409 

Decoctum Uva? Ursi . 409 

Ext. Uva? Ursi Fluidum . 409 

Valeriana .... 409 

Extractum Valeriana? . 410 



XX 



CONTENTS. 



Ext. Valerianae Fluidum . 410 
Infusum Valerianae . 410 I 

Oleum Valerianae . • 410 
Tinctura Valerianae . 410 

Tinct. Valerianae Ammon. 410 
Acidum Valerianicuni . 410 
Ammonii Valerian as . 410 
Quiniae Valerian as . . 410 | 
Zinci Valerianas . .410 
Vanilla . . . . 411 j 
Veratrum Album . . 411 ! 

Veratrum Viride . .411 
Ext. Verat. Vir. Fluid. . 411 
Tinctura Veratri Viridis . 411 

Vina 413 

Ziwcum .... 413 

Zinci Oxidum . . .413 



Ung. Zinci Oxidi . . 413 

Zinci Oxidum Venale . 413 

Zinci Chloridum . . 413 

Liquor Zinci Chloridi . 413 

Zinci Acetas . . . 413 

Zinci Carb. Praecipitata . 413 

Cerat. Zinci Carbonatis . 413 

Zinci Sulphas . . . 413 

Zinci Valerianas . . 413 

Zingiber .... 415 

Ext. Zingiberis Fluidum 415 

Infusum Zingiberis . . 415 

Oleo-resina Zingiberis . 416 

Syrupus Zingiberis . . 416 

Tinctura Zingiberis . 416 

Trochisci Zingiberis . 416 



SECTION III. 

Remedies in Frequent Use, but not included in the Primary 

List, U. S. P. 



Amyl Nitris 


. 417 


Kamala (Rottlera) 


. 431 


Areca 


. 420 


Laricis Cortex . 


. 431 


Azedarach . 


. 420 


Laurocerasi Folia 


. 432 


BELiE FRUCTUS 


. 420 


Mori Succus 


. 432 


Brayera 


. 421 


Nitroglycerin um 


. 432 


Casca Bark 


. 421 


Nitrous Oxide Gas 


. 433 


Curare 


. 422 


Pepsina Porci 


. 433 


Curcuma 


. 423 


Petroselinum 


. 434 


Eucalyptus Globulus . 


. 424 


Rhamni Succus . 


. 434 


Farina Tritici . 


. 424 


Salicin 


. 434 


Fel Bovinum Purificatum 


. 424 


Acidum Salicylicum 


. 435 


Gtoa Powder 


. 425 


SUMBUL 


. 438 


Jaborandi . 


. 425 


Thymol 


. 438 


PlLOCARPIN . 


. 426 


Trimethlamine . 


. 439 


Liquor Ferri Dialysatus 


. 430 


Leeches 


. 439 



Poisons ...... 

Prompt Treatment Table of Poisons 
Questions for the Student 
Weights and Measures . 

Metric System 
Index of Diseases . 
General Index 



. 440 
. 441 
. 447 
. 454 
. 455 
. 459 
. 477 



THERAPEUTICS 



AND 



MATERIA MEDICA. 



INTRODUCTION. 

Previous to the study of the individual articles com- 
prised within our national Pharmacopoeia, the temptation is 
very strong to launch forth into a disquisition upon the gen- 
eral principles of therapeutics. So many interesting physi- 
ological considerations are involved in the actions and uses 
of drugs, and so many important illustrations might readily 
be drawn from the wide field of practical medicine, that little 
apology would really be needed for consuming some of our 
space in this way. Therapeutics has lately shown a system- 
atic vitality which amply redeems its credit from the old- 
fashioned accusation of want of progress, for perhaps in no 
other department of our profession have more solid and 
satisfactory advances been made. But this very condition 
of vigor renders far more laborious and responsible the task 
of attempting to reduce to anything like precision the laws 
on which we are henceforth to prescribe our drugs, or to 
draw complete generalizations from the enormous mass of 
complicated material now at our disposal. Progress occa- 
sionally causes temporary confusion, by disturbing old beliefs 
and furnishing vast legions of sometimes unconfirmed and 
possibly ill-digested facts ; and our present subject is by no 
means exempt from this almost inevitable tendency of true 
science. 

A careful study of the many exhaustive works on thera-. 
peutics published within the last twenty years brings before 
us a strange medley of experimental evidence, confusing and 
contradictory it may be at times, but giving most encour- 
2 



14 INTRODUCTION. 

aging proofs of the large amount of honest and persevering 
work now being devoted to the elucidation of this, the most 
important department of practical medicine. In the follow- 
ing pages I must necessarily assume a dogmatic attitude, and 
if the extreme precision with which my plan compels me to 
lay down the actions of drugs offends many whose faith is 
undeveloped or wavering, I can only excuse myself by plead- 
ing a conscientious desire to contribute something towards a 
more scientific scheme of arrangement. Although the time 
has not yet fully come for a complete explanation of all the 
therapeutical effects of medicinal agents by their proved 
physiological properties, I have ventured to take a step in 
this direction, and must only hope that my very defects and 
failures may be of use in helping others to develop these prin- 
ciples with greater success. 

I have also thought it well, in this second edition, to enter 
upon a brief] consideration of the different modes by which 
drugs may be made to enter the system, as some important 
therapeutical points may thus obtain due notice, which might 
otherwise be neglected. The further consideration of the 
manifold ways in which they may act, after getting into the 
blood, is the main object of this little work — an object 
which will be best attained by carefully avoiding the will-o'- 
the-wisp which might lead me on to the unsteady ground on 
which ultimate therapeutical laws at present stand. 

Finally, as a feature of some importance, I should consider 
the series of questions with which the work concludes, and 
which aims at being in the light of ' puzzles' as Mrs. Faucett 
expresses it in her admirable little manual of ' Political 
Economy,' or rather of suggestive teachings on the border- 
land between therapeutics and medicine, than as the sort of 
somewhat sapless query and reply affected by educational 
treatises. 



THE ROUTES BY WHICH MEDICINES ENTER 
THE CIRCULATION. 

1. External Method of Application By this I 

do not mean the merely local action of irritants, caustics, 
or sedatives, but the attempts which we make to utilize 
the absorptive function of the cutaneous surface for thera- 
peutic purposes. Now, the skin would, at first sight, seem 



ROUTES BY WHICH MEDICINES ENTER, ETC. 15 

to be a very convenient and tempting arrangement for pass- 
ing our medicines directly into the blood ; but unfortunately 
for this purpose, the vascular cutis vera is protected by the 
horny epidermis, which interposes a very considerable bar- 
rier to absorption. Much discussion has arisen on this 
point, and it now seems pretty certain that many drugs can- 
not permeate the epidermis readily, if at all, and hence this — 
(a) the epidermic, as it has been styled, or the method by 
inunction — is not of very wide application, save in the ad- 
ministration of mercury, which is thus readily admitted, and 
sometimes belladonna and digitalis. Fats and oils, and pro- 
bably glycerine, increase our chances of procuring absorp- 
tion in this way, as they are undoubtedly absorbed. 

The cuticle, then, being our chief obstacle, it would seem 
an easy matter to overcome the resistance by its removal, 
and indeed this, (&) the endermic plan, as it is called, 
has done some good service in therapeutics. Having pro- 
cured a raw surface by a blister, we may apply morphia, 
strychnia, or any drug we may wish to use, directly to the 
cutis vera, and thus obtain an undeniably active effect. But 
the process is slow and painful, it may be disfiguring, and 
cannot be very frequently repeated, and it has therefore been, 
justly, almost entirely superseded by the (c) hypodermic 
plan. This, being a rapid, economical, and most efficient 
proceeding, has come into very general use, the principal 
drawback being that the pleasant, soothing influence and re- 
lief from pain which morphia thus gives our patients has 
introduced a form of opium-habit, perhaps hardly less obsti- 
nately adhered to than the older-fashioned form. Unfortu- 
nately, however, not all drugs, nor even all alkaloids, are 
available for this method of administration, as two conditions 
are requisite for success — the fluid to be injected must be 
small in bulk, and it must be unirritating to the parts. 
Chloral has been thus used, but without much success ; 
quinine, though efficient, is unhappily irritating; 1 ergotine 
produces hard, discolored, and painful lumps; mercury often 
causes abscess; and practically we are almost restricted to 
morphia, atropia, and strychnia, and of these the first named 
is by far the most available. We may refer to a description 
of the way in which the little operation is performed, under 

1 [A case has recently been reported of death from tetanus follow- 
ing a hypodermic injection of quinia in a healthy man.] 



16 INTRODUCTION. 

the subject, Opium, remembering always that drugs act three 
or four times more powerfully when given by hypodermic in- 
jection than by the mouth. 

Some authorities advise us to carry these injections boldly 
into the substance of the muscles, and it is said that strych- 
nia thus acts well in some forms of paralysis, but of this I 
have no personal experience. [Deep injections are less lia- 
ble to cause abscess than superficial ones.] 

Then, again, injections may be made directly into the 
veins, and this would, theoretically, seem to be the best, be- 
cause the most straightforward of all methods. We must 
not forget, however, that many drugs require to be acted 
on by some of the digestive juices before their due therapeu- 
tic powers are developed, and that the dangers of phlebitis, 
thrombosis, and of the admission of air into the veins, with all 
their perilous consequences, cannot be overlooked, (d) Intra- 
venous injection is therefore reserved for very desperate 
cases, and the most notable illustration is in the operation 
for transfusion, by which, after severe hemorrhage, lives 
have undoubtedly been saved. The intra-venous injection 
of chloral, so much praised abroad, has, so far as I know, 
been hardly practised at home. [It has not found general 
favor because it has proved suddenly fatal in several cases.] 

2. Internal Administration 1. Inhalation must 

stand first, on account of the great facility of its application, 
of its remarkable efficiency, and of the great purity, so to 
speak, with which drugs thus enter the blood. Anaesthesia 
produced by chloroform, ether, or laughing-gas will occur, 
as the leading example, to every mind, and we know that the 
British Pharmacopoeia has recently acknowledged the prin- 
ciple by the admission of five vapors — creasote, iodine, 
hydrocyanic acid, chlorine, and conium. But little use, 
however, has yet been made of this tempting channel for the 
administration of agents intended to act on the system gene- 
rally, perhaps partly because it is a matter of doubt as to 
how far the delicate structures of the air-cells might be tol- 
erant of the prolonged or repeated contact with possibly 
irritating substances. At present, inhalation has been almost 
confined to the treatment of lung diseases, and ipecacuanha, 
arsenic, stramonium, tannin, and carbolic acid have been 
thus employed ; but there is no doubt that this plan is capa- 
ble of much wider development, and that the Germans are 
far ahead of us in this respect. It is evident, however, that 



ROUTES BY WHICH MEDICINES ENTER, ETC. IT 

a barrier must always exist to the very extended adoption 
of aerial medication, by the irritant nature of many medi- 
cines, and the impossibility of reducing many of them to that 
minute subdivision which is essential for either ordinary in- 
halation or the formation of a readily absorbable spray. 

2. Medicinal agents may be injected into any of the open 
cavities of the body. The rectum is much used in this way, 
and enemata, clysters or injections as they are called, may 
be divided into three classes. 

a. Purgative Enemata. — For efficient and easy evacua- 
tion of the large bowel, no method can compare to this, the 
principal points to remember being that the injection must 
be ample, from three to five pints, must be passed up as far 
as possible, and must be retained as long as the patient is 
able. They may be composed of water alone, of salt and 
water, of gruel or oil, or of any of the purgative enemata 
contained in the Pharmacopoeia (Br.), and their function is 
not only to act mechanically by washing out the contents of 
the lower bowel, but to stimulate its peristaltic movements, 
which they do very efficiently. 

b. Those enemata which are intended for absorption, and 
which must, therefore, be small in quantity (^j— ij), so as not 
to excite the expulsive movements of the gut. The princi- 
pal of these is the enema opii, so highly prized on account 
of its restraining influence on the diarrhoea of typhoid and 
phthisis, and on account of the happy way in which it soothes 
pain, not only in the rectum, but, by nervous sympathy, also 
in the neighboring bladder and uterus. Astringent drugs 
are also occasionally used in this way, whilst assafoetida, 
ipecacuanha, etc., find their special applications, which will 
be considered elsewhere, although we may here lay down the 
general rule, that drugs, with one exception (strychnia), act 
about half less powerfully by the rectum than by the stomach. 

Another mode of utilizing the absorptive power of the 
bowel is by suppositories, which are pastille-shaped masses of 
medicated oil of theobroma, wax, and lard, which are readily 
introduced within the sphincter ani, and where they readily 
melt at the temperature of the body. 

c. Nutrient enemata are of great service in cases where swal- 
lowing is prevented by cancer or stricture of the oesophagus, 
or where we wish to give the stomach, irritated by the pre- 
sence of chronic ulcer, a thorough rest. The great difficulty, 
of course, is that the rectum, although it absorbs readily, has 

2* 



18 INTRODUCTION. 

no digestive function, so that we must either compose our 
enema of very simple materials, or else add pepsin and acid, 
or pancreatic fluid. Meat and pancreas enemata, formed of 
one pound of finely minced beef, free from fat or cellular tis- 
sue, with about three ounces of pancreas, kept a patient alive 
for nine months. 

3. We now come to the most widely used, convenient, and 
generally available mode of using medicines, by introduction 
into the stomach. Swallowing a dose at stated intervals in- 
volves far less trouble and general annoyance, than the other 
plans we have just passed in review, and, after all, is of 
almost universal application in ordinary cases. Occasion- 
ally, where patients will not or cannot swallow, we require 
to pump food, or drugs, artificially into the stomach, but, as 
a general rule, there is no difficulty on that score. It only 
remains for us now to consider the drawbacks we have to 
surmount. 

First. The patient is made fully aware of the too fre- 
quently nauseous taste of his medicine, and we must endeavor 
to conceal this by flavoring ingredients, by capsules, or other 
means. 

Secondly. Our drugs may spoil the appetite, injure the 
digestion, lower the tone of the system, cause nausea and 
depression, and general discomfort, and this we may partly 
avoid by timing their administration at judicious intervals. 

Thirdly. By coming in contact with various secretions, 
the remedy is much altered before it reaches the blood. The 
salivary, pancreatic, or biliary fluids, on the one hand, and 
the gastric juice on the other, must largely neutralize acid 
and alkaline remedies, whilst some drugs may be rendered 
partly inert by stomach digestion, or, like curare, may be 
eliminated too rapidly by the kidney to exert any poisonous 
influence when taken by the mouth. But we must also re- 
member that these and other actions give us substantial 
therapeutic aid. The bile aids the absorption of our oily 
remedies, the gastric juice aids the solution and absorption 
of quinine and other drugs. Many purgatives only act effect- 
ually after previous solution in the alkali of the bile, etc. 

4. Drugs are occasionally injected into the bladder, but 
its absorptive power is very limited, if it exist at all, and it 
is usually only the mucous membrane which is locally at- 
tacked in this way by weak acids, alkalies, quinine, opium, 
and the like. 



RULES FOR PRESCRIBING. 19 



GENERAL RULES FOR PRESCRIBING. 

Preliminary Considerations It will be well, be- 
fore proceeding further, that I should lay down some broad 
rules which may guide us in the construction of prescrip- 
tions ; and it seems best to introduce this subject here, in- 
stead of placing it, according to more usual custom, at the 
end of the book, as it is to be our aim and object to devote 
much care and attention throughout to the best modes of 
ordering drugs. Much professional credit may be derived 
from a good prescription, and as much damage done to the 
practitioner who orders for his patients mixtures which are 
neither agreeable to the eye nor palatable to the taste. It 
is well worthy of the student's attention to consider the most 
pleasant, effectual, and convenient way of ordering the drugs 
which are required by the sick, and at first he will no doubt 
consider this a very difficult task. This will partly depend 
on the fact that he has had the subject of doses and thera- 
peutical actions presented to him in such concentrated form 
that he will find some awkwardness in using practically the 
theoretical knowledge which he has laboriously obtained. 
The time at his teacher's disposal is so short that he has to 
run hurriedly from one drug to another, and bring into im- 
mediate relation remedies which differ so widely in their 
effects as to excite some not unnatural confusion in the 
minds of his hearers. It is therefore not an uncommon 
thing to hear students say that they do not think they will 
ever be able to remember the doses of the principal medi- 
cines. Then we must remember that, during attendance on 
out-patient practice, prescribing is either done on very rou- 
tine principles, or considerations of time and convenience 
render it advisable to order most drugs according to regis- 
tered formulas, which are merely referred to on the patient's 
notes by name. Thus, although the student may know that 
dyspepsia may be treated by mist. alk. amara, or debility by 
mist, quinire, he would perhaps experience some difficulty in 
writing a prescription suitable for either case. In the wards, 
of course, he sees much more prescribing, but is perhaps not 
often called upon to do it for himself, so that, when he settles 
down on his own account, it will be some time before he can 
handle medicines with that ease, confidence, and certainty, 
which can alone conduce to the comfort of his patients and 



20 INTRODUCTION. 

his own ultimate success. Now it cannot be out of place to 
urge upon him, here, the great importance of frequently exer- 
cising himself in this art. Let him put problems to himself, 
let him run his eye through his text-books, and endeavor to 
order the several drugs in varied combination ; when he 
meets with the recommendation to treat a certain disease in 
a certain way, let him there and then expand these more or 
less vague directions into the form of a prescription ; and so, 
at last, due blending of ingredients, with the avoidance of 
incompatibles and the concealment of nauseous properties, 
will come to him with perfect ease and efficiency. 

Another point, the mere mention of which may cause a 
smile, is the importance of occasionally inspecting, or even 
tasting, the mixtures we prescribe for our patients. Experi- 
ments of this nature will often do more to teach us the effi- 
cient combination of drugs than the most profound theoretical 
knowledge. It is by the experience gained in his own sur- 
gery that the country doctor is often found to order far more 
agreeable prescriptions than the hospital physician, and to 
steer clear of those hopelessly nasty concoctions which are 
occasionally sent out from the unwilling hands of druggists 
in obedience to the orders of scientific authority. 

1. Combination of Drugs The first thing to be 

considered in writing a prescription is the object for which 
we order this certain combination of drugs, which symptoms 
in our patient's case do we wish to alter or modify, what is 
to be our principal ingredient, and in what quantity. This 
being duly settled in our minds, we reflect whether it is bet- 
ter to give this particular article by itself, or to combine it 
with other substances which may possibly assist or mitigate 
its action, or may at all events conceal its more or less 
nauseous taste. Now it is a very commonly given recom- 
mendation that in our prescriptions we should aim at sim- 
plicity as much as possible, and this certainly holds good 
within certain limits. The old-fashioned custom used to be 
to string together a long list of ill-understood substances, in 
the hope that some one or other of them might hit the right 
nail on the head, and even now traces of this polypharmacy 
linger about medical practice. When, however, we are tol- 
erably certain of the action of our drug, and more especially 
when we are making: scientific observations on its mode of 
action, it is often of great importance that we should not 
obscure its effects by the addition of any other active sub- 



RULES FOR PRESCRIBING. 21 

stances, but order it either simply in distilled water, or merely 
combined with other ingredients for flavoring purposes. But 
we must remember not to carry this principle too far. No 
fact is more thoroughly proved in therapeutics than the value, 
under certain conditions, of due combination, and the way 
in which one drug may assist the action of another. 

Thus, taking the case of diuretics, we know well that a 
prescription containing three or four members of this group 
will often act where one produces little or no effect, and that 
mercury is of undoubted service in assisting the influence of 
squill and digitalis over the urinary secretion. Cough med- 
icines are always best given in combination with a variety 
of drugs, and the same holds good of purgatives ; for we all 
know how hyoscyamus or belladonna will both aid and hold 
in check the action of colocynth, how a little sulphuric acid 
and iron will promote that of sulphate of magnesia, how jalap 
aids the peristaltic intestinal contraction to remove the 
watery fluid which cream of tartar drains into the bowels. 

Moreover, we all gladly acknowledge the advantage to 
be derived by the addition of a little iron to the digitalis 
which we give as a cardiac tonic, and to the ergot which is 
to stimulate the uterine functions, knowing, as we do, the 
important role which an improved blood supply necessarily 
plays under these circumstances. Narcotics also often gain 
in potency by combination, for do we not know that bromide 
of potassium and chloral together will occasionally cause 
sleep where either separately would have failed? More- 
over, the use of compound anaesthetic vapors has been much 
popularized of late for this reason. Aromatics are often of 
great service in counteracting the griping tendencies of cer- 
tain active purgatives, and the success which has been 
claimed in some special conditions for Warburg's tincture 
over quinine, is held to be due to the peculiar way in which 
the action of the active ingredient is reinforced by the some- 
what complicated farrago of substances by which it is sur- 
rounded. 

Arsenic is believed by some to prevent the unsightly acne 
produced by bromide of potassium; and the best mode of 
obviating the discomfort of cinchonism consists in adding a 
little hydrobromic acid to our quinine. 

[The combination of a small amount of opium or morphia 
with quinia has been also found to prevent the occurrence of 
the disagreeable nervous symptoms that sometimes occur, 



22 INTRODUCTION. 

and at the same time it increases the antiperiodic power of 
the drug, so that smaller doses produce the same therapeutic 
effect.] 

Several alkaline medicines, given together, seem to act bet- 
ter in rheumatic fever than the simple administration of one 
member of the group. Tonics, such as quinine and iron, are 
blended with advantage. Then again, we add one drug to 
another for the purpose of counteracting some unpleasant 
physiological effect ; thus spiritus ammonia? aromaticus miti- 
gates the unpleasant symptom of iodism, and atropia lessens 
the chances of discomfort which attend the subcutaneous in- 
jection of morphia. Instances like this might be multiplied 
almost ad infinitum ; but we shall develop the subject further 
as we go on, and refer frequently to the laws which should 
guide us in considering whether the various drugs are best 
ordered singly or in combination. 

2. Form of Administration We must take into 

consideration whether. we ought to administer our drug in a 
concentrated or diluted form, and here again we shall find 
it necessary to act very differently under different circum- 
stances. As a general rule, we may lay down that the 
metals are best given either in pill or in a small quantity of 
fluid, and this remark applies more especially to those which" 
have very active physiological properties. Thus we gene- 
rally give arsenic and perchloride of mercury [corrosive sub- 
limate] in a state of only moderate dilution. Salts, on the 
other hand, and more especially the purgative salts, act best 
when taken in large quantities of fluid, and we shall find in 
practice that iodide of potassium is decidedly more effica- 
cious when freely diluted, that sulphate of magnesia follows 
the same rule, and that in the case of diuretics also we may 
aid their action by combining the directly flooding or me- 
chanically sluicing effect on the kidney of large quantities of 
watery fluid. 

3. Proper Time for Exhibition The period of 

administration is also well deserving of careful study, and 
we may indicate one or two useful rules with regard to the 
action of alkalies and acids. As acids check acid secretions, 
and alkalies have a similar influence over those with alkaline 
reaction and vice versa, we can readily understand the effect 
which they may exercise over digestion. Thus an acid given 
directly before a meal must interfere with the due assimila- 
tion of the nitrogenous articles of diet by checking the sup- 



RULES FOR PRESCRIBING. 23 

plies of gastric juice, whereas an alkali given at the same 
time must theoretically produce the best results by stimu- 
lating that secretion. If, on the other hand, we give an 
alkaline medicine after food, we do harm by directly neu- 
tralizing the acid on which some part at least of the active 
principles of the gastric juice depends. 1 

Drugs which have a distinctly lowering or irritating effect 
on the system are best given with or after meals, so as to 
prevent these results as far as possible ; thus we always give 
arsenic or corrosive sublimate Or strychnine at these times, 
and find that they are well borne by persons who could not 
take them on an empty stomach. For a different reason, 
again, we generally find it convenient to prescribe cod-liver 
oil after food, not only because it is less likely to cause sick- 
ness when given at that time, but because oily matters being 
absorbed by the lacteals are most readily taken up when 
these structures are in full working order. 

Again, when we wish to imitate or excite a normal phy- 
siological action, we must time our drug accordingly. Opium, 
or any other narcotic, is much more likely to produce sleep 
when taken at night than at other times, and a mild purga- 
tive in the morning will often stimulate the peristaltic move- 
ment of the intestines to evacuate the bowels at the time 
when they are accustomed to act. Again, when we wish to 
re-excite a suspended menstrual flow, we will find our best 
chance of success in directing our remedies more especially 
about the time at which the monthly period ought naturally 
to appear. 

The efficacy of purgatives is also markedly aided by a due 
consideration of the periods at which they ought to be given. 
A resinoid cathartic principle contained in pill is usually of 
slow and deliberate action, and may be given indifferently 
with meals — as in the case of dinner-pills — or on an empty 
stomach before bed-time ; but saline purgatives generally act 

[' An important point for the student to learn at the outset is, 
that nothing can be more fallacious than a priori reasoning concern- 
ing the therapeutical effects of remedies. Cases of atonic dyspepsia 
with acid eructations are frequently benefited by dilute mineral 
acids ; and a combination of muriatic acid (gtt. iij) with saccha- 
rated pepsin (gr. x) in water (f'§ss;, given either directly after or 
before meals, is constantly prescribed with good results for patients 
with impaired or weak digestion. Indigestion with pyrosis, or 
flatulence, may often be relieved by alkalies after meals.] 



24 INTRODUCTION. 

best when given fasting, as the veins of the intestinal tract 
are then less full and more predisposed to rapid absorption. 
As an illustration of this we need only refer to the much 
more potent effect of an ordinary seidlitz powder given before 
than after breakfast. 

Anthelmintics, again, are always best given after as long 
a fast as possible, so that the parasites which they attack 
may not be shielded by food or mucus, and we find in prac- 
tice that early morning is the most convenient period for 
their administration. 

4. Dosage The relative efficiency of large and small 

doses is the next point which has to be taken into consider- 
ation ; and here we are at once confronted by some of the 
most delicate and difficult questions in therapeutics — delicate 
because they border closely on the dangerous ground of 
homoeopathy, difficult on account of their often unsettled 
nature. We cannot pretend to give any exhaustive discus- 
sion to this branch of our subject, because the materials for 
it are not forthcoming, but w T e can all contribute somewhat 
to its solution by experimental trials of various drugs given 
in these different ways. This much, however, we do know, 
that in many cases we get far more satisfactory results in 
special emergencies, or temporary conditions, by giving one 
tolerably large dose at one time ; and especially is this the 
case with narcotics, small quantities of which only excite 
and annoy, whilst a full dose satisfactorily brings about the 
desired result of sleep. Purgatives and emetics, again, are 
also best given in one considerable dose ; tonics, astringents, 
and diuretics require to be steadily repeated at certain short 
and regular intervals in order to have a sustained and con- 
tinued effect. But the true point at which we wish to arrive 
is this : Can we best obtain rapidly and efficiently the con- 
stitutional action of a drug such as belladonna, or aconite, 
by administering in average quantities two or three times a 
day, or by ordering it to be taken in very small doses often 
repeated ? Now supposing we are called upon to treat a 
case of acute tonsillitis or catarrhal febrile disturbance, which 
we wish to remove as rapidly as possible, and we elect 
aconite as the special remedy to be used, the most reliable 
method for its administration is in drop or even half-drop 
doses every hour, half hour, or even ten minutes, General 
experience has pretty well confirmed this teaching, and has 
extended it to other medicines, such as prussic acid, which 



RULES FOR PRESCRIBING. 25 

will thus more effectually control urgent sickness than when 
given at longer intervals in the more canonical way ; to tar- 
tar emetic, which in very small and often-repeated quantities, 
exercises a remarkable effect over infantile bronchitis ; to 
ipecacuanha, which in minim doses will frequently check 
obstinate vomiting ; to calomel and gray powder, which in 
minute doses, every half hour, will often stop irritability of 
the stomach when nothing else will succeed. Instances of 
this sort will be multiplied as our consideration of the indi- 
vidual articles of the Pharmacopoeia goes on, the principle 
being steadily kept in mind that we may often bring the 
system much more efficiently under the special influence of a 
drug, by ordering it in small quantity often repeated, than 
by giving full doses two. or three times a day ; and this neces- 
sarily applies with special force to those drugs which are 
rapidly thrown out of the system, and whose action upon the 
structure or function they are particularly supposed to effect, 
is thus kept up and, so to speak, perpetuated, by very fre- 
quent administration. 

On the other hand, we must not forget that certain medi- 
cines must be given in very large quantities before their 
physiological properties are obtained. Thus it would be 
useless to expect succus conii to tranquillize irregular mus- 
cular movement in less closes than f ^j £Ph. B. ; the succus 
conii, U. S. P., cannot be safely given in such large amounts, 
as its strength is variable]. Frequently w T e are required to 
give even more than this ; belladonna is of no use in noc- 
turnal incontinence of urine unless boldly pushed up to f 5,j or 
f 5jss of the tincture. [In this connection it should be borne 
in mind that the tincture of belladonna of the U. S. Pharma- 
copoeia is twice the strength of the British.] Arsenic acts 
best in chorea when prescribed with no timid hand. 

Another point of interest in connection w r ith this inquiry 
is, that drugs often display different and even opposing 
actions, accordingly as they are given in large or small doses. 
Thus we have seen that drop doses of vin. ipecac, will often 
check vomiting, whereas it is well known that a teaspoonful 
or even less, w r ill almost immediately evacuate the stomach ; 
sulphate of zinc, in tw T enty or thirty grain doses, is prized as 
our best emetic, whilst it is equally established that from 
one to ten grains is a valuable nervine tonic, much used by 
some physicians in the treatment of chorea. [Quinia in 
doses of from two to five grains is a tonic ; from six to ten 
3 



26 INTRODUCTION. 

grains, a, stimulant ; and in large doses is an anti-periodic 
and febrifuge.] Small closes of opium excite, whilst large 
soothe into sleep ; half-ounce doses of infusion of digitalis 
may be more safely given than those of f'3j more frequently 
repeated ; the neutral salts of potash and soda are, as a rule, 
purgative in large, diuretic in small, doses ; and the other 
instances of this principle — which will afterwards be given 
— must be borne in the mind of the prescribe!* before he can 
pretend to make most efficient use of the weapons at his 
disposal. 

5. The Interval between Doses The next head- 
ing to which reference is usually made is regarding how 
often we ought to repeat our dose of medicine ; but this is so 
far involved in what has gone before, that very little remains 
to be said. The ordinary rule is to order our mixture to be 
taken three times a day, or every four hours, unless special 
circumstances, such as we have already indicated, render it 
advisable to repeat more frequently. Although many sick 
persons look forward to the time pf taking their physic, and 
feel moral as well as physical support from the mere act of 
attending to their doctor's orders, the greater proportion are 
not so favorably impressed, and would willingly be relieved 
from the necessity of swallowing the often nauseous com- 
pounds they receive. Homoeopathists, no doubt, derive 
much of their success from the tasteless nature of their med- 
icines, and we have not yet devoted sufficient attention to 
the elegances and refinements of pharmacy. It is well, 
therefore, to direct our tonics and astringents, and drugs 
whose action is to be spread over some considerable time, to 
be taken three times a day, always bearing in mind those 
important exceptions which recent investigation has done 
such good service in impressing upon our attention. 

6. Individual Peculiarities ; Idiosyncrasy ; 
Habit. — When the student has been fairly emancipated 
from the leading-strings of his teachers, and enters practice 
on his own account, he will often be disappointed at the way 
in which drugs play their allotted parts. The necessarily 
cut-and-dried and dogmatic descriptions of the text-books 
have led him to believe that such and such a medicine will 
always act in a particular way, and he accordingly prescribes 
it with full confidence in a given case. But not only may 
the proper effects fail of development, but very unpleasant 
and almost unlooked-for symptoms may follow its use, which 



RULES FOR PRESCRIBING. 21 

will be productive of much discomfort and uncertainty, and 
may even tend to shake his professional credit. The in- 
fluence of that strange individual peculiarity, usually termed 
idiosyncrasy, and of which no reasonable explanation has 
ever been given, must be very carefully taken into account 
in prescribing, and we shall refer to it on all suitable occa- 
sions. Sometimes it renders our patient unduly susceptible 
to the action of drugs, and thus we may find one person 
seriously salivated by one grain of calomel, another who 
dare not touch quinine, a third who is furiously excited by 
opium, whilst a fourth may be poisoned by a single grain of 
morphia. Phosphorus and bromide of potassium also occa- 
sionally cause their peculiar effects in very small doses. A 
good precaution, therefore, is, before prescribing any of these 
drugs, to ascertain from the patient whether he has ever 
taken any of them before, and whether uncomfortable effects 
could be in any way attributable to their use. But, on the 
other hand, our patient's constitution may be such that very 
large quantities of drugs will alone succeed in acting ; and 
remarkable stories are told by Christison and others of the 
immense quantities of opium which persons quite unaccus- 
tomed to its use have been occasionally able to take with 
impunity. Purgatives act very differently on different peo- 
ple, and some require immense quantities of anaesthetic 
vapor before full insensibility is obtained. Although, as I 
have just said, we may often anticipate uncomfortable effects 
by due preliminary inquiry, it too often happens that they 
come on suddenly, and quite unexpectedly. Idiosyncrasy is 
so wide-spread and deep-rooted in the human constitution, in 
almost every function and action, that we can hardly hope 
ever to obtain the key to its mysteries. Why, may we ask, 
do particular articles of diet disagree with special persons ? 
Why does one person, on exposure to cold, take a simple 
catarrh, whilst a second becomes a prey to rheumatic fever, 
and a third escapes unharmed ? Why do we all differ from 
one another in some minor degree in almost everything that 
we do ? Until we can clear up these problems, it is vain for 
us to attempt to explain why we require to adapt our doses 
so carefully to individual constitution and peculiarity ; and 
the reason why the student is at first perplexed by all this is 
that we meet with these differences much more frequently in 
the upper ranks of society. The hospital or dispensary pa- 
tient swallows any dose, however nauseous, witli much satis- 



28 INTRODUCTION. 

faction, and is much less often affected by those troubles of 
irregular physiological action which so frequently harass the 
family medical attendant in more aristocratic circles. 

The power therefore, and a power unfortunately too often 
uncommunicable to others, of appreciating the peculiarities 
of different persons in respect of their "behavior" towards 
drugs, is just one of those " knacks" which go far to make 
up success in practice. We ourselves often wonder, or share 
the surprise of others, why certain doctors, whose scientific 
attainments may be none of the highest, attract and retain 
in a remarkable way the confidence of their patients ; and 
we may be sure that something beyond mere luck, or manner, 
or accident, is the true secret of their superiority. Tact in 
the use of remedies is no doubt in some degree the lever 
which has raised them to their positions, and more especially 
the power which well-remembered experience has conferred 
upon them of knowing intuitively, as we sometimes call it, 
what drugs will best agree with the individual sufferer. We 
yet know nothing of idiosyncrasy beyond the uncomfortable 
fact of its frequent and unsuspected existence, and, in pro- 
portion to our ignorance, all the more keen and persevering 
should be our search after those laws which must inevitably 
regulate its action. This it is which makes, and in the pre- 
sent state of our knowledge always must make, the deduc- 
tion from experiment on animals so often fallacious when 
applied to the human subject. I am far from wishing to 
undervalue the benefits conferred on our science by experi- 
ment, but we must remember that brutes have their idiosyn- 
crasies as well as ourselves, and, until both are thoroughly 
understood, therapeutics will lack much of the precision 
which it must eventually attain. And for the further 
elucidation of our own eccentricities in this way we must 
mainly trust to the labors of family practitioners, who will, 
we hope, be induced to publish the names from their great field 
of observation far more copiously than heretofore. 

The influence of habit on therapeutics is also worthy of 
every consideration, for we shall find in practice that medi- 
cines often lose their effect when continued for any length- 
ened period. More especially is this the case with opiates 
and narcotics generally, the dose of which requires to be 
gradually increased from time to time. Arsenic has the 
same peculiarity, as is shown in the case of the arsenic- 
eaters of Styria, who, by long continuance in the use of that 



RULES FOR PRESCRIBING. 29 

substance, are at last able to consume quantities which would 
inevitably prove fatal to a novice. And this leads to the 
question of toleration, an old-fashioned term dating from the 
days of heavy dosing with irritating metallic substances, but 
having sufficient bearing on modern practice to justify its 
consideration here. We have said that the term toleration 
savors somewhat of antiquity, because the great illustration 
of this principle used to be afforded by tartar emetic, which 
was then much more freely used in acute inflammations 
than now ; and when I say antiquity I do not refer to any- 
thing more remote than perhaps half a century ago. Then 
the contra-stimulant treatment of pneumonia was in full 
swing, and the curious fact became gradually known that, 
although the first doses of tartar emetic, often caused much 
nausea and depression, subsequently larger quantities were 
well borne ; and this was explained by what was called 
toleration of the drug being established in the system. It 
will be seen, when we come to consider in detail the actions 
and uses of tartar emetic, that a very sufficient and scientific 
explanation can be given of this somewhat mysterious effect. 
In these days, inflammatory action is treated on somewhat 
different principles, and antimony is comparatively little 
used ; but the principle of toleration can be recognized in 
the use of other drugs. Thus, in dysentery, quantities of 
ipecacuanha are given which would infallibly produce vio- 
lent vomiting in a healthy subject ; arsenic is better borne 
in skin disease than in a state of health ; choreic patients 
are able to swallow almost emetic closes of zinc sulphate 
without the action of vomiting being induced. Digitalis is 

o © © 

well known to be given freely in delirium tremens, and 
there is little doubt that the experiment of prescribing half 
an ounce of the tincture to a person in ordinary health 
would be productive of serious if not fatal consequences. 
Further instances of toleration might readily be adduced, 
but it will be much more to the advantage of the student to 
recommend him to pick out other examples for himself than 
to provide him with a cut-and-dried list of all that is known 
on the subject. 

7. Constitutional or Toxic Effect from Small 
Doses. — We next come to what is commonly known as 
accumulation, the theory of Avhich is that certain drugs rest 
or become stored up in the system until they reach a dan- 
gerous quantity, w T hen inconvenient or poisonous symptoms 

3* 



30 INTRODUCTION. 

may result. Thus we know that after a certain continuance 
in the use of digitalis, faintness and depression have often 
been observed, that strychnia may cause uncomfortable 
twitchings after it has been taken for some time, that bro- 
mide of potassium only begins to cause annoyance when the 
system seems to have become saturated with the salt. Does 
this really mean that these substances have reached the 
point beyond which their poisonous action is neutralized, so 
to speak, by the symptoms which their therapeutical powers 
attack, or is the defect in the organs of elimination which 
fail to expel them efficiently from the system ? It is proba- 
ble that both these and the numerous other examples which 
our subsequent pages will contain depend on both these 
causes in some degree, in addition to another, and that is 
that the organ or tissue towards which the physiological 
action of the drug is directed is, after long-continued stimu- 
lation by repeated small doses, worked up into a certain con- 
dition of special excitement or depression, and discharges 
accordingly. Thus we find the twitchings from strychnia, 
the cardiac depression of digitalis, the nervous weakness 
and ataxy from bromide of potassium, the paralysis resulting 
from alcohol. The metals, as mercury, arsenic, etc., on the 
other hand, no doubt act by being stored up within the tis- 
sues, being brought into excessive action by some defect of 
elimination. 

And the practical outcome is, that in prescribing many of 
these drugs, and more especially digitalis, strychnia, and 
bromide of potassium, it is well to have an occasional break, 
to omit our prescription for a day or two, so as to give the 
parts a rest, and enable the remedy to act afterwards with 
better effect perhaps in even diminished dose. It may happen 
that some of these uncomfortable effects are caused by defects 
in the organs of elimination. It is very important, when pre- 
scribing certain drugs, and more especially salicylic acid, to 
satisfy ourselves, by careful examination of the urine, that 
the kidneys are in thoroughly good working order. 

8. Chemical and Physiological Incompatibil- 
ities. — And now we come to the doctrine of incompatibility, 
which is of all-essential importance in therapeutics, consisting 
as it does of the principles which we require to know in 
order to avoid that amount of clashing of the different ingre- 
dients of our prescription which may either alter or destroy 
their action. Now incompatibility may be of different sorts, 



RULES FOR PRESCRIBING. 31 

and is generally divided into chemical and physiological. 
Of these we will first consider chemical incompatibility. 

This consists in the chemical action of one drug on an- 
other, which may result in the formation of a new compound 
when they are mixed. Thus the addition of iron to decoc- 
tion of cinchona will produce an unsightly, black mixture ; 
strychnia and perchloride of mercury will not go with gela- 
tine ; sulphuric acid and lead form an insoluble sulphate. A 
good deal of this incompatibility, however, is inconvenient, 
principally, because the resulting solution is often thick, tur- 
bid, and unsightly,, and therefore repugnant to the patient. 
Many most incompatible mixtures are therapeutically effi- 
cient, and some are even prescribed deliberately. Quite 
otherwise is it, however, with the second group, or the physi- 
ological incompatibles, the rationale of which is that the 
action of one drug is so far antagonistic to that of another 
that the mixture of the two is necessarily inert. Thus the 
combination of belladonna and opium is in some degree op- 
posed, so is atropia and prussic acid, aconite and digitalis, 
strychnia and Calabar bean, and, most markedly of all, caustic 
alkalies with belladonna, hyoscyamus, stramonium, or to- 
bacco, all of whose active principles are thus absolutely 
destroyed. 

But, as already hinted, we often prescribe an incompatible 
mixture for the purpose of actually deriving therapeutic 
advantage from the resulting compound. Thus what is a 
more generally used and, I may confidently say, more useful 
prescription than bichloride of mercury and iodide of potas- 
sium, making an iodide of mercury, which is much more 
efficacious than that salt itself as prepared by more elaborate 
chemical agency? 1 Again, the far-famed mist, ferri co. de- 
rives much of its charm from the freshly prepared carbonate 
of iron which results from the due combination of ferric sul- 
phate and potassium carbonate. Black wash is another 
example ; and although corrosive sublimate and decoction of 
bark are undoubtedly incompatible, no better means is known 

1 [Theoretically these salts in solution are chemically incompat- 
ible, as a reaction takes place, and a precipitate is formed. This 
precipitate, however, is soluble in an excess of potassic iodide, 
forming an uncertain compound, which may be looked upon as a 
hydrargyro-potassic iodide, dissolved in a solution of potassic 
chloride, with other compounds not positively determined.] 



32 INTRODUCTION. 

of counteracting the depressing effects of this preparation of 
mercury. 

[Some of the principles of incompatibility, as applied to 
the writing of prescriptions, may be conveniently formulated 
as follows : — 

General Principles of the Incompatibility of Drugs 1. 

As a rule a drug; is incomnatible with its antidotes and its 
chemical tests, especially if the latter depend upon the form- 
ing of an insoluble precipitate ; thus metallic salts or albumen 
should not be prescribed with substances containing tannin, 
nor chlorides with nitrate of silver. Therefore, in combining 
soluble salts with each other, or with infusions, be careful to 
see that an insoluble precipitate is not unintentionally formed. 

2. The alkaloids are precipitated by tannic acid and caustic 
alkalies, and may be destroyed by chlorinous compounds. 

3. The alkalies, as a rule, precipitate metallic salts. 

4. Mineral acids decompose salts of vegetable acids, and 
other salts where they have a superior affinity. They form 
ethers with alcoholic preparations. 

5. The glucosides, such as salicin, santonin, and colo- 
cynth, are decomposed by free acids, or emulsin. 

6. Tinctures in general deposit resin on adding water, 
which also precipitates iodine from its alcoholic solution. 
Infusions containing tannic acid are incompatible with 
metallic salts generally. 

Special Incompatibles — In accordance with the first rule 
given above, the table of antidotes placed at the end of the 
book will for the most part suggest the individual incom- 
patibilities. 

The following should always be exhibited alone, or sim- 
ply dissolved in distilled water : corrosive sublimate, tannic 
acid, strychnia, preparations of lead and of iodine, and nitrate 
of silver. With glucosides, or creasote, the latter forms an 
explosive compound, and should not be prescribed with 
vegetable extracts. 

A mixture of chromic acid and alcohol is explosive, and 
so is chlorate of potassa, when powdered with sulphur or 
tannic acid. 

Aromatic waters sometimes precipitate metallic salts, on 
account of containing a small amount of carbonate of mag- 
nesia. 

Syrup of squill and of garlic contain free acetic acid, and 
are incompatible with carbonates. 



RULES FOR PRESCRIBING. 33 

Tincture of chloride of iron precipitates quinia from the 
solution of quinia sulphate, but to a small extent dissolves it 
when in large excess. 

Solution of acacia gelatinizes with tincture of the chloride 
of iron and with borax. It is precipitated by solution of sub- 
acetate of lead, and by alcohol.] 

9. Prescribing for Children. — A few words may 
now be said on the art of prescribing for children, a subject 
which is only incidentally touched upon in our ordinary 
books, and is then treated in a somewhat misleading manner. 
Elaborate tables have, however, been drawn up for the regu- 
lation of doses according to age, and in all of these it is 
assumed that young children necessarily require much 
smaller doses of most drugs than adults ; and this is true in 
so far that it is seldom advisable to deal out our mixtures to 
them in the time-honored tablespoonful or two tablespoon- 
fuls of their elders. But the important fact which these sys- 
tems invariably ignore is this, that children can often take, 
not only with impunity, but even with decided benefit, quan- 
tities of active remedies which will correspond to the full adult 
dose. And the reason of this may be looked for in the much 
greater destruction and construction of tissue in early life, 
whereby the organs of elimination are in unusual activity, 
and hence disposed to excrete medicinal substances with 
special promptitude. Whether we accept this explanation 
or not, however, I may warn the young practitioner that an 
adherence to the rules usually laid down for children's pre- 
scriptions will cause him serious disappointment, and that he 
will be surprised at the beneficial results which will often 
follow the adoption of a bolder course. 

To furnish a few examples of this proposition, I will begin 
with belladonna, which may be used very freely in child- 
hood, and the dose of which I have pushed in a child of ten 
years of age suffering from incontinence of urine, to f3ij 1 
with good effect, and the development of only very mild 
forms of physiological disturbance. I commonly begin with 
tt^xx 1 in a child of two or three, and have prescribed n^x 1 
in an infant of six months with remarkable benefit ; and the 
result of my experience undoubtedly is, that children bear 
belladonna actually better than grown-up persons, and that in 
them really poisonous symptoms rarely if ever occur. I may 

1 [British Pharmacopoeia.] 



34 INTRODUCTION. 

add that this strange insusceptibility of children to bella- 
donna was first pointed out by the late Dr. Fuller, and has 
since been abundantly confirmed by Dickinson, Ringer, 
Kelly, and others. 

Arsenic may also be freely given to children, and, at the 
age of five or six, I should have no hesitation in bejrinnino; 
with tt^v [of Fowler's solution] and pushing even up to n^x 
if necessary. Strychnia is also well borne. Tinct. ferri 
may be taken in large quantities, and I have seen excellent 
results follow the administration of f 3j ter die, in a little girl 
of six years. 

Children will often require large purgative doses, more 
especially of pulv. jalap, co., and of ipecacuanha as an 
emetic. I have often ordered quantities which have start- 
led the dispenser, and induced him to come for explanation 
under the idea that I had made a mistake. Bromide of 
potassium may also be freely given, and other instances will 
be noted as we go on, remembering always the sound old 
advice to be very careful with opium at an early period of 
life. Every practitioner has no doubt seen cases in which 
ill results have unexpectedly followed laudanum prescribed 
before the age of one year, and I cannot do more than reite- 
rate the warnings on this subject which every manual of 
materia medica most properly contains. The explanation of 
this possibly enough may be, that the open fontanelles of 
early childhood permit a much more sudden and effective 
increase in the quantity of blood contained within the skull 
than in adult life, and some confirmation of such an opinion 
may be found in the fact that very young infants will usually 
bear large doses of those narcotics which act by causing an- 
aemia of the brain, and notably of chloral hydrate, which I 
have prescribed with benefit in five-grain doses thrice a day 
to a little child only twelve months old. 

It is always well to make our dose as small as possible, 
one or two teaspoonfuls being usually sufficient, and great 
pains must be taken, by means of well-adjusted flavoring in- 
gredients, to disguise the too often nauseous taste of our 
drugs. Various syrups and aromatic waters here stand us in 
good stead, and it is well if possible, when dealing with very 
young infants, so to reduce the bulk of the medicine as to 
enable it to be mixed unobserved with milk, veal-broth, 
beef-tea, or some sort of confection. In this there is nothing 
really antagonistic to the principle which has just been de- 



RULES FOR PRESCRIBING. 35 

veloped, as we can readily enough <rive considerable quanti- 
ties of belladonna, arsenic, etc., in comparatively small 
quantities of water, or even in none at all. 

Children are, however, somewhat strangely capricious in 
their taste ; for whilst they object decidedly to bitter or acid 
substances, they will take oils readily, and generally seem to 
derive satisfaction from sucking in cod-liver oil. Nauseous 
powders which would seem inexpressibly revolting to their 
elders, they often take well, and by a little contriving and 
consideration we can generally manage to persuade them to 
consume their dose with philosophic composure, if not with 
actual relish. 

We may now briefly consider two very interesting points. 

First, the effects of drugs administered to a nursing 
mother on the child. Of this, of course, we have ample evi- 
dence, knowing, as we do, of the elimination of many medi- 
cines by the milk, such as iodide and bromide of potassium, 
rhubarb, and lead. We often find that infants are griped and 
made uncomfortable by their mother's medicine, and w r e 
must remember this in prescribing, even if we are allowed 
to forget it by the patients themselves, who are usually well 
informed on this point. But little advantage has hitherto 
been taken of this way of treating young children, and it 
seems hardly admissible to recommend a larger recourse to 
so roundabout a plan, as some of the substances used in this 
Avay might check the secretion of the milk by impairing the 
health of the mother, and as there is no real difficulty in 
giving effective doses of therapeutic agents to children even 
at so early an age. 

When we come to number two, however, some interesting 
speculations are encouraged, for we have to consider in how 
far we can modify or affect the condition of the foetus in 
utero by drugs administered to the mother. There is no 
doubt that a strain of syphilitic infection has been arrested 
by mercury given to the mother during pregnancy, and that 
the infant thus vicariously treated was the first out of a long 
series which proved to be free from all specific taint. Iodine 
and salicylic acid have been detected in the urine of the 
foetus whose mother had taken those substances, and Dr. 
McClintock, of Dublin, records six cases in which the regu- 
lar recurrence of abortions was checked by giving iron and 
chlorate of potash 1 to the mother. For a full ventilation of 

1 Brit. Med. Journal. 



36 INTRODUCTION. 

this subject, and a large mass of evidence and opinions on 
either side, we may refer the reader to a discussion in the 
New York Obstetrical Society, January, 1877. 

10. Prescription Writing We next come to the 

construction, or what we may call the anatomy, of the pre- 
scription itself, how it is put together, and how its compo- 
nent parts are arranged; and we commence with the ' &' 
with which it begins, and which really means an old invoca- 
tion to Jupiter. But, conventionally, it has been held to 
imply the verb recipe, which governs the quantity in the 
accusative, the name of the medicine being put in the geni- 
tive. Thus, Recipe (take) pulveris (of powder) scammonice 
(of scammony) scrupulum (a scruple), etc. Other direc- 
tions are laid down in books which deal with this question, 
and much valuable information is contained in Pereira's 
' Selects Praescriptis' and the clear and instructive little 
work of Dr. Griffith, of Dublin ; but it is hardly necessary 
to reproduce these here, as students beginning their medical 
curriculum are presumably sufficiently well grounded in 
classics to enable them to understand the very moderate 
amount of Latin required for their use in prescribing. As a 
rule, most medical men write their directions now-a-days in 
English ; and this has not only the advantage of limiting the 
chance of mistake, but it does away with much of that mys- 
tery which beyond anything else has tended to keep back 
the progress of our art. In these enlightened times, when 
even more than a smattering of physic is commonly pos- 
sessed by the laity, we do not find our patients quietly con- 
senting to be kept in the dark as to what medicines they are 
taking. Rather we find them showing a keen interest in 
our prescriptions, anxious to inquire, and argue, and, if pos- 
sible, understand all about the line of treatment we have 
determined to pursue. The cases are very rare in which it 
is necessary to conceal from them the presence of any par- 
ticular drug in their mixture, and Latin directions are 
therefore not only unnecessary, but pedantic in the highest 
degree. It is still, however, the custom at examining 
boards to ask the candidates to write and to read prescrip- 
tions fully constructed according to this custom, and in the 
prescriptions which we shall frequently add to our descrip- 
tions of the various drugs we shall invariably give the direc- 
tions in Latin of the usual form. 



RULES FOR PRESCRIBING. 



37 



11. Weights and Measures It only remains for 

us, then, to add the signs and symbols in general use, which 
are as follows : — 



gr., granum 
9, scrupulum (scruple) 
%, drachma (drachm) 
Sj, uncia (ounce troy) 
lb, libra (pound) . 

IT\,, minimum 

f£, fluidrachma (fluid 

drachm) 
f§, fluiduncia (fluid 

ounce) 
0, octarius (pint) . 

C, congius (gallon) 



3 scruples 
8 drachms 
12 ounces troy 



8 fluid drachms 
16 fluid ounces, 

U. S. P., 
8 pints 



1 grain. 
20 grains. 
60 grains. 

480 grains. 
. 5760 grains. 

1 minim. 

60 minims. 

. 480 minims. 

. 7680 minims. 
61440 minims. 



In the British Pharmacopoeia the time-honored drachm 
and scruple weights have been discarded, and all who pre- 
scribe or dispense medicines are recommended to discon- 
tinue their use ; but old-fashioned customs are not so readily 
swept away, and we accordingly find these most convenient 
terms flourishing as much as ever. In domestic practice we 
find a much more rough-and-ready mode of prescribing, the 
generally received measurements being as follows : — 



Drop, usually about j? minim 

Teaspoonful 

Desertspoonful 

Tables poonful 

Wineglassful 

Teacupful 

Breakfast-cupful 

Tumbler 



= gtt., gutta. 

= 1 fluid drachm. 

== 2 fluid drachms. 

= 4 fluid drachms. 

= 1^ to 2 fluid ounces. 

= 5 fluid ounces. 

= 8 fluid ounces. 

= 10 to 12 fluid ounces. 



Of all domestic modes of measurement, however, none can 
equal the drop in fallacy and danger. The size of a drop is 
influenced first by the shape of the bottle, and secondly by 
the quality of the fluid itself, and hardly any two substances 
will be found to contain the same number of drops in a given 
quantity. 

Tablespoons, teaspoons, and all domestic measures are 
most absurdly variable in size, and we shall do well steadily 
to discountenance their use in all cases, and to insist that our 
patients shall carefully regulate their dose by means of those 
graduated glasses which are within the reach of all but the 
very poorest. 
4 



38 INTRODUCTION. 

12. Observations upon Doses. — Now, although it 
would manifestly be lulling our readers into a false security, 
were we to attempt to lay down any absolute rules respecting 
dosage, we may venture to state some broad principles 
which will help the memory. Students often complain of 
the great difficulty they experience in remembering doses, 
and at first sight it would appear a most irksome task for a 
person not in the habit of prescribing to carry in his mind 
the major and minor quantities of drugs which he may safely 
order. But by giving a few rules, and adding exceptions, 
as in the Latin grammar, we hope to show that there is no 
real difficulty here, but that we may safely group substances 
in such a way as to associate their doses with one another 
with tolerable simplicity. But first let me say one word 
about the British Pharmacopoeia. Constructed as it was by 
official authority several years ago, it is naturally looked upon 
as our vade mecitm, and every student is supposed to possess 
a copy and to make himself familiar with its contents. Now, 
in the first edition no doses were given, and in the next, al- 
though these were added in deference to a universal request, 
it was expressly stated that they were not to be considered 
authoritative, or specially enforced by the Medical Council. 
But the Pharmacopoeia, being the only official guide, has 
now been forced into a position respecting dosage which it 
did not intend nor desire, and we therefore find that in any 
case of difficulty its authority is invariably appealed to. It 
lies on every druggist's counter, it is the standard in courts 
of justice, and, this being the case, it ought to reflect the 
most advanced researches on its subject. But this is not 
so; on many points its recommendations are hopelessly at 
variance with modern practice, and we are hence exposed 
to the annoyance and possible discredit of having our pre- 
scription sent back or cut down by druggists who are afraid 
of exceeding the dose sanctioned by authority. Thus the 
maximum dose of succus conii is fixed by the Pharmacopoeia 
at f'5j, of quinine at gr. x, digitalis f'3J ; and when we come 
to consider the various substances in succession, we shall 
find many other examples of a discrepancy between my 
teaching and its statements, which this explanation will clear 
up. [These difficulties are happily avoided by the United 
States Pharmacopoeia, the doses of remedies being judiciously 
omitted.] 



GENERAL PLAN OF ARRANGEMENT. 39 

13. General Rule for Doses We may now proceed 

to indicate the natural system of grouping, by which some 
order may be given to the arrangement of the doses of drugs 
in the already crowded brain of the student or the young 
practitioner. 

Thus let him remember that, as a general rule, tinctures 
may be prescribed in doses of from n^x to f'3J, infusions 
and decoctions from f^ss to ^ij, powders from two to ten 
grains, pills four to ten grains ; and although there are nu- 
merous and very important exceptions to this, the recollection 
of the principle will spare us from the drudgery of placing 
the exact dose after every preparation whose action we shall 
examine. 

[The following are the important exceptions to this rule, 
the dose of each of which should be learned separately. 

Tinctura aconiti radicis, U. S. P. Tinctura nucis vomica, U. S. P. 

" belladonna?, " " opii, " 

11 cannabis, " " " acetata, " 

" cantliaridis, " " " deodorata, " 

" colcliici, " " scilhe, " 

" conii, " " stramonii, " 

" digitalis, " " veratri viridis, " 

" ferri chloridi, " Infusum digitalis, " 

" hyoscyami, " " capsici, " 

" iodinii, " " tabaci, " ] 

" iodinii composita, " 

These rules may be borne in mind in a general way, and 
we shall now go on to consider very briefly the plan of ar- 
rangement to be pursued when we come to consider the 
various medicinal substances seriatim. 



Our object will be in the following pages, in discussing the 
properties of drugs, to balance, as far as possible, their phy- 
siological against their therapeutical action, arranging them 
in corresponding columns in diagrammatic form ; and it will 
greatly assist this arrangement, as well as aid the memory of 
the student, if we adopt the following order in stating what 
we know respecting the properties of each drug. 

Take, first, its local or external action. 

Then its influence on the brain and on the spinal and sym- 
pathetic system of nerves. 

This will lead us up gradually to the effects on the heart 
and bloodvessels, whose functions are presided over, and 
ruled by, nervous influence. 



40 INTRODUCTION. 

The effects of the drug on respiration and temperature will 
next be considered, and we then proceed to the alterations 
of secretion in the following order, urinary, intestinal, sali- 
vary, cutaneous, etc. 

Then other actions which come under no heading, and 
which may be called specific. 

Finally, we must consider the various modes of elimina- 
tion from the body, the antidotes, contra-indications, and 
best modes of prescribing; winding up, in most cases, with a 
prescription which will, as far as possible, combine efficiency 
and elegance with palatability. 

It will of course often happen that we cannot accurately 
balance the physiological against the therapeutical action of 
a drug, either from want of sufficient knowledge or from an 
excess of facts of more or less conflicting nature. We must 
remember that our therapeutical evidence is derived from 
clinical observation on man, and that experiment on the 
lower animals lias supplied us with most of our knowledge 
respecting the action of medicinal agents on the healthy 
organism. Fallacies may readily creep into both these 
methods of investigation, and it is evident how the clinical 
method may be hampered by our want of full knowledge of 
the natural history of disease. Although late years have 
done a good deal in showing how various acute maladies be- 
have, when uncomplicated in their course by active medi- 
cation, we are still much in the dark, and too prone to 
confuse the propter with the post. And the results of the 
very elaborate system of experimentation, which has lately 
been carried on in Germany and elsewhere, cannot be ac- 
cepted as fully conclusive of the physiological action of the 
various drugs on man. One source of fallacy undoubtedly 
lies in the very differing susceptibility of certain members of 
the brute creation to certain drugs. Thus rabbits freely 
digest belladonna as well as opium ; it is difficult to poison 
pigeons with strychnia, or fowls with prussic acid ; and other 
instances of this curious law have been placed on record. 
It is therefore reasonable to suppose that the special struc- 
ture and habits of the lower animals exercise an equally 
modifying influence with regard to the special action of 
medicinal substances on special organs and functions, so that 
we must be prepared to receive some facts drawn from this 
source with a certain amount of reserve. In addition to 
this, the shock and general damage inflicted on the victims 



GENERAL PLAN OF ARRANGEMENT. 41 

of experiment by the necessary manipulations must fre- 
quently alter so seriously the conditions of secretion as to 
render any deductions on this score very inconclusive ; 
whilst, finally, it is well known that drugs which appear to 
have no action on a special organ whilst in health may very 
materially modify its condition when congestion or any other 
form of morbid action has set in. In looking over, there- 
fore, the large mass of evidence furnished by the industry of 
able physiologists, we cannot fail to be struck by the dis- 
crepancy which exists occasionally between the results ob- 
tained. Skilled observers experimenting in different ways 
now and then get different results, and in no case has this 
been more distinctly shown than by the way in which the 
labors of the celebrated Edinburgh Committee have been 
practically set aside by later investigators, who have shown 
that mercurials, as well as other drugs, actually do increase 
the biliary secretion. We must therefore bear all this in 
mind, and endeavor so to sift all our evidence as to place in 
our tables only that which the opinion of our best authori- 
ties has thoroughly and fully endorsed. 

In making observations on drugs, we must never forget to 
allow for the varying action which they may have on the 
system in health and in disease. A remedy which has no 
special physiological influence on the normal organism, will 
exert a very appreciable effect on morbid conditions, either 
by removing some obstruction to the natural processes of 
nutrition or secretion, or by supplying the want of some 
vitally essential substance. Thus, antipyretics, like alcohol, 
quinine, digitalis, and the like, produce their lowering effect 
on the body heat far more effectually under pyrexial than 
normal conditions. Iron and phosphorus, which increase 
the number of the red corpuscles in amemia, have no such 
action in healthy blood ; and mercury, which will blanch a 
sound skin, will speedily restore a healthy bloom to the vic- 
tim of syphilis. Other instances will present themselves in 
the following pages, and the principle is one which must 
always steadily be held in view. 

Regarding the method in which the following pages will 
be arranged, a few words may be said. 

Different modes of grouping drugs have been adopted, and 
by some the preference is given to the purely physiological 
plan, by which all the medical substances having a particular 
action are placed under that special heading ; thus we have 

4* 



42 INTRODUCTION. 

purgatives, narcotics, astringents, etc., as different varieties, 
with their attendant species. No doubt such a plan has the 
merit of scientific precision, and, had each drug only one 
medicinal action, nothing could be simpler or more effective 
than this arrangement, of which Neligan is the chief expo- 
nent. But an unfortunate element of complication is intro- 
duced by the fact that one drug may act in many and indeed 
opposing ways. Thus, whilst opium is an astringent, it has 
every right, under certain circumstances, to be called a pur- 
gative ; its stimulant action is as evident as its narcotic ; it 
is a diaphoretic, a sedative, an antiphlogistic, and the con- 
fusion inseparable from hunting it about among its various 
headings must necessarily be perplexing to the mind of the 
student, as well as occasion loss of time. Many other drugs 
behave in the same way, so it has been thought best to adopt 
the arrangement of the Pharmacopoeia, in which all the 
substances are placed alphabetically. We shall only ven- 
ture to make one modification, and that will be to discuss in 
the succeeding section some of the general considerations 
underlying the action of certain remedies, which may be 
considered as the general principles of therapeutics. It will 
be observed, however, that we have not presented in tabular 
form a collected group of every class of substances acting, or 
appearing to act, in the same way, simply on account of the 
excessive vagueness of the evidence on which the action is 
often sought to be explained. For instance, all we know 
with any certainty about astringents is, that the really effec- 
tive members of the family, like ergot, act by directly con- 
stringing the vessels, and so arresting hemorrhage ; and in 
spite of the ingenious pleadings of Lauder Brunton, I cannot 
sanction by any formal notice the term alterative, which 
means nothing in itself, and cannot be galvanized into scien- 
tific vitality even by the learned treatment of my friend. 
Considerations of space, also, have induced me to disregard 
certain other groups usually patronized by text-books ; for it 
has seemed hardly necessary to repeat in mere formal ar- 
rangement the facts and cautions given elsewhere under the 
various anaesthetics. But I have retained and discussed at 
some length all those broad divisions which are necessary 
either for examination purposes, or for the fuller and wider 
development of important therapeutical laws. 



THE METRIC SYSTEM IN MEDICINE. 43 



THE METRIC SYSTEM IN MEDICINE. 1 

OLD STYLE. METRIC. 

TTi j or gr. j equals ....... 06 Gm, 

f3Jor.3J " 4 

fgjorgj " 32 

The decimal line instead of points makes errors impossible. 

As .06 (Drug) is less than a grain, while 4. and 32. 
(Vehicle) are more than the drachm and ounce, there is no 
danger of giving too large doses of strong drugs. 

C. C. (cubic centimetres) used for Gms. (Grammes) 
causes an error of 5 per cent, (excess). 

A teaspoonful is usually 5 Gms.; a tablespoonful 20 Gms. 

1 For a complete exposition of the metric system, see Weights 
and Measures at the end of the hook. 



REMARKS 



ON 



CERTAIN CLASSES OF REMEDIES. 



ACIDS. 

"We will first take up the consideration of acids, and, before 
enumerating the therapeutic properties of each individual 
member of the group, it will save time and repetition if we 
draw attention to the collective actions and uses of acids in 
general. 

External Action. 



Physiological. 

Acids, being possessed of 
high diffusive power, rapidly 
permeate tissues to which 
they may be applied, coagu- 
lating their albumen, and, if 
concentrated, absorbing their 
watery constituents and caus- 
ing their destruction. 



Therapeutical. 

Acids, if used in concen- 
trated form, therefore, act as 
caustics, eating away and 
destroying animal tissues. 
When more diluted they are 
astringents, hardening and 
constringing weakened parts 
and checking unhealthy se- 
cretions. 



Internal Action. 



1. On Circulation It is 

stated that phosphoric and 
acetic acids diminish the force 
and frequency of the pulse, 
and reduce the number of 
blood corpuscles. 

All the acids, however, 
have the property of increas- 
ing the acids of the blood, 



1. No therapeutical use, 
however, has been made of 
this physiological deduction 
from experiment. 



The action of acids in 
checking hemorrhage is thus 
explained, as there is no doubt 



46 



ACIDS. 



probably rather by setting 
free another acid than by a 
direct action on that fluid ; 
for by the time they enter the 
circulation they are them- 
selves converted in great 
measure into salts by the va- 
rious alkaline secretions with 
which they have come in con- 
tact. 

They may also contract 
the smaller bloodvessels by 
reflex action, or by directly 
astringing them locally. 

2. No special effects on the 
respiration or nervous system 
have been noted, but phos- 
phoric and acetic acids are 
said slightly to lower the tem- 
perature. 

3. Their action on secre- 
tion is interesting, and has 
been specially pointed out by 
Ringer. It appears that an 
acid applied to the orifice of 
a gland secreting an acid fluid 
will check that secretion, and 
thus any member of this 
group taken into the stomach 
before or at the beginning of 
the process of digestion will 
tend to act unfavorably by 
stopping the flow of gastric 
juice. 



that coagulation of fibrin in 
the vessels is prevented, and 
its fluid condition normally 
maintained and encouraged 
by an alkaline condition of 
the blood. 



They are useful in internal 
hemorrhage, and to check ex- 
cessive perspiration. 



3. This physiological action 
points to a valuable bearing 
on therapeutics. Some cases 
of dyspepsia depend on a de- 
ficient production of gastric 
juice, enough of this fluid 
not being secreted under the 
stimulus of food to dissolve 
and digest the albuminous 
constituents. This condition 
may be remedied by mechani- 
cally supplying the want by 
a little acid given some time 
after food. But again, still 
more cases of disordered di- 
gestion are caused by an ex- 
cessive formation of gastric 
juice, the surplus supply of 
acid teasing and worrying 
the mucous membrane of the 
stomach, and causing pain, 
sour eructations, and general 
distress. Here our physio- 



ACIDS. 



47 



But if acids arrest secre- 
tions having their own chem- 
ical reaction, they stimulate 
those which are alkaline, 
markedly increasing their 
quantity. 



4. On the Urine. — Acids 
increase somewhat the acidity 
of the normal urine, but have 
no power of rendering an al- 
kaline urine acid. This pro- 
perty is alone possessed by 
benzoic and citric acids. 



logical law comes into play, 
and we check the over-secre- 
tion by giving the acid im- 
mediately before the meal. 
Or again, discomfort may re- 
sult from irregular or exces- 
sive fermentation of food «;iv- 
in«; rise to the formation of 
a large quantity of acetic, 
butyric, and lactic acids; and 
this undue fermentation is 
found to be itself directly con- 
trolled by acids given in this 
case after food. Possibly some 
of their influence in checking 
acid perspiration may be due 
to this law. 

We can thus explain what 
has been called the refriger- 
ant action of acids, or their 
undoubted influence in reliev- 
ing thirst and imparting a fic- 
titious sensation of coolness. 
By stimulating the secretion 
of the salivary glands, we 
moisten the dry, parched 
mouth of our fever patient, 
and quench his thirst perhaps 
better than in any other way. 

It is probable also that 
some at least of the beneficial 
influence exerted by acids on 
chronic biliary derangement 
is due to their directly in- 
creasing the flow of alkaline 
fluid from the liver. 

4. An alkaline state of the 
urine being due either to spi- 
nal debility or actual disease, 
the action of alkaline rem- 
edies, some dyspeptic ten- 
dency, or to local bladder 
causes, it must be variously 



48 ANAESTHETICS. 

treated by appropriate reme- 
dies. 
Acids, by their astringent They are, therefore, good 
properties, brace up relaxed tonics, and act well in diar- 
mucous membranes, and rhoea and profuse sweating, 
check unhealthy secretion. 

Disadvantages. 

The prolonged use of acids is apt to exercise a very un- 
favorable influence on digestion, rendering persons pale and 
languid, and causing a good deal of emaciation ; and this 

was no doubt the secret of the action of vinegar in reducing 

© © 

corpulence, which used to be so highly prized in the Byronic 
days, and by incautious indulgence in which so many igno- 
rant people have at various times ruined their health. 

Poisonous Effects. 

The symptoms consist of very violent burning pain in the 
stomach and intestines, vomiting, purging, intense prostra- 
tion, and death either by shock or by the results of secondary 
inflammation. On post-mortem examination, intense inflam- 
mation of the stomach and intestines is found, with ulcera- 
tion of the mucous membrane, and even perforation into the 
peritoneal cavity ; and if the case is of a more lingering 
character, fatty degeneration of various internal organs, but 
more especially the kidneys, becomes gradually developed. 

ANAESTHETICS. 

For a full discussion of the physiological and other pro- 
perties of anaesthetics the reader is referred to the subjects of 
Ether, Chloroform, and Nitrous Oxide Gas in the succeed- 
ing section. The consideration of their relative value, as 
stated by Dr. Clover, may be here briefly considered under 
the head of 

The Choice of Anaesthetics. 

[For ordinary surgical cases, ether is safer than chloro- 
form. 

Chloroform is most suitable for children and for aged per- 
sons with brittle arteries, also for sustaining the anaesthesia 
during protracted operations inside the mouth. In some cases 



ANTHELMINTICS. 49 

of operation on the eye, when it is desirable to diminish the 
hemorrhage, chloroform is better than ether. In midwifery 
practice the same may be said. 

Laughing-gas is best for ordinary tooth-extraction, for re- 
ducing luxations or moving stiff joints, for opening abscesses 
and fistulas, and other cases where anaesthesia is required only 
for a short time. For those operations which last from five 
to fifteen minutes it is found that laughing-gas, followed by 
a small quantity of ether and a very limited supply of fresh 
air, is the anaesthetic least often attended by sickness. The 
recovery of sensation is, however, much more rapid than 
when chloroform or ether alone has been used to the same 
effect, and where great pain is expected to result, a hypoder- 
mic injection of morphia is also needed. 

The mixture of nitrite of amyl with chloroform has been 
strongly advocated recently by Dr. Sandford, an American 
physician. I have tried it in a dozen cases, and find that it 
produces insensibility rapidly, and, if the anaesthetic is then 
removed, the recovery is very satisfactory ; but when the in- 
halation is continued for three or four minutes there seems 
to be nearly as much subsequent depression and nausea as if 
pure chloroform were given. The nitrite has also the effect 
of producing a sense of fulness in the head in the surgeon 
and assistants, which is rather objectionable. — C] 

ANTHELMINTICS. 

The human body being infested with various parasites, 
whose presence is inconvenient and even dangerous, it is 
necessary for us to be provided with means for their safe and 
speedy removal. Some of these unwelcome guests are, un- 
fortunately, out of the range of medicine, but others are so 
placed that they can readily be destroyed ; and we shall ar- 
range them in classes, according to the several drugs which 
act especially upon them. 

1. Tape-worms are, 1. The best remedy for the 

the taenia solium, derived from teniae is now believed to be 

eating measly pork ; the taenia male-fern oil given on an 

medio-canellata, from veal or empty stomach ; but if this 

beef ; and the taenia lata, from should possibly fail, we may 

salmon. These occupy the have recourse to kousso, tur- 
5 



50 



ANTHELMINTICS. 



small intestines, and give rise 
to various ill-defined but un- 
comfortable sensations ; the 
only truly diagnostic symp- 
tom being the actual passing 
of joints by stool. 



2. The round-worm, or 
asearis lumbricoides, 
inhabits the small intestine, 
and occasions a long array of 
nervous symptoms, more es- 
pecially in children. These 
worms are supposed to be in- 
troduced into the system by 
impure water. 

3. The thread- worm, 
or oxyuris vermieula- 
ris, is found in the caecum or 
colon, and causes much itch- 
ing and irritation. They are 
almost universal among the 
children of the poor, but 
opinions differ as to whether 
they must be regarded as the 
cause or the effect of the pe- 
culiarly cachectic condition 
with which their presence so 
often coincides. 

Other forms of parasitic 
intrusion within the various 
tissues are well known, but 
are generally incurable ; and 
the trichina spiralis and the 
various forms of hydatid dis- 
ease, when placed in inacces- 
sible organs, must usually be 



pentine, pomegranate root, or 
areca nut. 

We must remember that, 
although these remedies kill 
the worms, they do not neces- 
sarily expel them from the in- 
testines, and that a purgative 
may be required for this pur- 
pose ; and it is also essential 
to find the head of the tape- 
worm before we can assure 
our patient that he is freed 
from his tormentor. 

2. Santonin acts as a true 
specific in at once destroying 
these troublesome parasites. 



3. It would seem rather a 
roundabout practice to attack 
parasites in the lower gut by 
drugs administered through 
the mouth; and although pur- 
gatives, such as scammony, 
calomel, jalap, etc., are of use 
in these cases, our chief re- 
liance must be placed on ene- 
mata of quassia, tincture of 
iron, lime-water, common 
salt, etc. 



In the general treatment 
of parasites, we must not trust 
entirely, however, to the use 
of anthelmintics, but must 
also exclude all possibility of 
infection by forbidding raw 
or underdone meat, or fish, 
and by insuring general clean- 



ANTIDOTES. 



51 



permitted to run their de- 
structive course unchecked. 
When hydatids are placed, 
however, in the liver, they 
are frequently effectually re- 
moved by tapping, whilst 
those in the lungs not uncom- 
monly undergo spontaneous 
cure. 



liness and an efficient water- 
supply. In addition to this, 
we must remedy the un- 
healthy condition of mucous 
membrane which favors their 
development, by giving alka- 
line remedies and bitter tonics 
in various forms of combina- 
tion. 



In prescribing our remedies for the expulsion of the tape- 
worm, it is well to insure a thorough evacuation of the intes- 
tines, so that the parasite may not be in any way shielded from 
the action of the drug by food or mucus. After a prelimi- 
nary purge, we direct our patient to fast for a few hours, and 
then administer the fern-oil in milk, either at bed-time or in 
early morning. 

Parasiticides. 



The various external para- 
sites which infest the body 
may be divided into : — 

1. Animal, including the 
Guinea-worm, the acarus sca- 
biei of the itch, and the va- 
rious pediculi met with on the 
head, pubis, and other hairy 
regions. 

2. Vegetable, to which pa- 
rasitic skin-diseases are due. 
Thus we have the micros- 
poron furfur of pityriasis ver- 
sicolor, the Achorion Schon- 
leinii of favus, the Trico- 
phyton tonsurans of tinea ton- 
surans, and the various other 
forms met with in tropical 
practice. 



1. The G-uinea-worm is re- 
moved by gentle traction ; the 
itch insect destroyed by sul- 
phur or staphisagria ; and the 
lice killed by mercurial ap- 
plications. 

2. The various parasitic 
diseases of the skin are of too 
well-known obstinacy, and 
may be treated in a variety 
of ways. Iodine, acetic acid, 
chrysophanic acid, mercurials, 
sulphurous acid, carbolic acid, 
and a long array of drugs 
have each their enthusiastic 
partisans. 



ANTIDOTES. 



The first thino- to be done 
in any case of poisoning is to 
empty the stomach, and to 



This may be effected in the 
first place by emetics, and 
more especially those of the 



52 



ANTIDOTES. 



eliminate the poisonous sub- 
stance from the tissues. Some 
qualification however must be 
made in the case of such rapid- 
ly absorbed and active poisons 
as prussic acid, in which the 
stomach-pump brings away 
nothing, and only adds to the 
general shock. We must here 
have recourse at once to No. 
2. 



The next stage in our pro- 
ceedings must be to obviate 
the tendency to death, ac- 
cording to the various vital 
processes attacked by the poi- 
son. 



Having got so far, we must 
then proceed to use our anti- 



direct class ; but it will often 
happen, particularly in nar- 
cotic poisoning, that emetics 
will not act, and that we are 
forced to have recourse to the 
stomach-pump. Caution in 
the use of this instrument, 
however, is requisite in cases 
of irritant poisoning in which 
the mucous membrane of the 
stomach is softened or par- 
tially destroyed. When eva- 
cuation of the stomach has 
been completed, we may em- 
ploy gentle purgatives and 
diuretics in addition to such 
remedies as iodide of potas- 
sium, which favor the elimi- 
nation of metallic substances. 

Thus, if cardiac syncope 
be the main symptom, we 
must give stimulants ; if the 
respiratory centre seems in 
danger of becoming para- 
lyzed, we must excite respi- 
ratory action by cold affu- 
sion, irritation of the skin, 
and the employment of arti- 
ficial respiration, and give 
atropia, which stimulates the 
origin of the pneumogastric 
nerve in the medulla ; if nar- 
cosis prevail, we must endea- 
vor to rouse the brain ; and 
if irritation of any particular 
organ arises, we must soothe 
it by appropriate remedies. 
[The aid of electricity will be 
found to be not only useful, 
but in some cases absolutely 
indispensable.] 

1. Among the first class 
we may rank alkalies in acid 



ANTIPYRETICS AND REFRIGERANTS. 



53 



dotes proper, which may be 
divided into (1) Chemical, 
which directly neutralize the 
action of the poison by de- 
stroying its properties ; and 
(2) Physiological, which have 
distinctly antagonistic proper- 
ties, being, indeed, in many 
cases, absolute counter-poi- 
sons, and the progress of phy- 
siology and therapeutics has 
recently largely added to our 
knowledge of these. 



poisoning, animal charcoal as 
rendering the vegetable alka- 
loids innocuous, and liquor po- 
tassse as depriving belladonna 
and its congeners of all phy- 
siological power. 

2. The second contains 
all those various substances 
which have been described 
here and there in these pages 
as directly antagonistic to 
one another, as opium within 
certain limits to belladonna, 
Calabar bean to atropia and 
strychnia, aconite to digita- 
lis ; and this class of antidotes 
has the advantage over the 
more purely local or chemi- 
cal, that they are able to pur- 
sue their foe into the blood, 
and attack it boldly and suc- 
cessfully there. [Antidotes to 
special poisons are considered 
under their appropriate head- 
ings in the succeeding sec- 
tions. At the close of the 
book will be found a con- 
densed " List of Poisons and 
their Antidotes" for conven- 
ient reference and study.] 



ANTIPYRETICS AND REFRIGERANTS. 



Antipyretics. 



Antipyretics are remedies 
which reduce the bodily tem- 
perature, some acting only 
against the preternatural heat 
of febrile conditions, whilst 
others can also cool down the 
natural warmth below the 



5* 



In this country we are not 
much in the habit of regard- 
ing the temperature, per se, 
as a special element of dan- 
ger, unless it goes beyond a 
certain height, and we, there- 
fore, do not, as a rule, treat 



54 



ANTIPVRETICS AND REFRIGERANTS. 



normal standard. We may 
thus divide their action : — 



Class 1. Those which act 
by directly cooling the sur- 
face of the body by local ap- 
plication. 



Class 2. Those which act 
by internal administration, 
either lessening oxidation, or 
exerting some special influ- 
ence on the nervous system. 



Class 3. Those which act 
by dilating the superficial 
vessels and enabling a larger 
sheet of blood to be spread 
over the cutaneous surface, 
and thus brought in contact 
with the cooling influence of 



this symptom very energeti- 
cally. Foreign experience- 
seems to show that, although 
we may reduce the actual heat 
in acute disease, we do not 
necessarily alter the course of 
the attack, and we, therefore, 
usually confine our efforts to 
supporting our patient and 
looking out for complications. 
On the other hand, however, 
when the thermometer regis- 
ters 105°, and still tends up- 
wards, we are bound to inter- 
fere. 

1. This is, undoubtedly, 
our most effectual antipyretic 
means, and may be carried 
out by cold affusion, wet pack, 
or, best of all, by the care- 
fully graduated cold bath. 

2. This class consists of 
the antipyretic drugs, pro- 
perly so called, such as qui- 
nine, digitalis, veratiia, alco- 
hol, salicylic acid, etc. ; but, 
with the exception of the last- 
named, they are not much 
used for this purpose. It is 
a remarkable fact, that very 
few, if any, of these drugs 
have the power of reducing 
the normal temperature, save 
when given in large and al- 
most poisonous doses {vide 
Alcohol and Quinine). 

3. Under this heading we 
must include the whole class 
of diaphoretics, as well as 
chloral hydrate, the warm 
and Turkish bath, etc. 



ANTIPYRETICS AND REFRIGERANTS. 55 

the air. The chilling effect 
then produced by the return 
of the circulating fluid to the 
heated centres, although very 
transient, may become con- 
siderable by repetition. 

Class 4. Remedies which 4. A rising temperature 

act by bracing up and being often an indication of 
strengthening the nervous debility, we may then check 
system, and removing some it by tonics, good food, small 
of that enfeebled and semi- doses of alcohol, etc. 
paralyzed condition on which 
febrile temperatures have 
been supposed to depend. 
Those who, like Lieber- 
meister, adopt the antipy- 
retic plan in its entirety, 
combine the various agents. 
Whilst using very frequent 
baths, as often as every two 
hours — in severe cases two 
hundred, even, having been 
given during one illness — he 
orders quinine in large doses, 
holding it first among cooling 
agents ; digitalis where the 
heart is strong, thus revers- 
ing our usual therapeutical 
rules ; and veratria, which 
seems to act by causing a 
kind of collapse. Statistics, 
however, do not show any 
superiority of this over the 
more expectant plan prac- 
tised in England. Prof. 
Gairdner ( Glasgow Med. 
Journal, September, 1878) 
well calls the German plan 
a battledore and shuttlecock 
treatment, consisting, as it 
does, "in keeping the pa- 
tient, partly by means of 
cold baths, and partly by 



56 ANTISEPTICS AND DISINFECTANTS. 

these other remedies, in a 
state of constant oscillation 
between fever and incipient 
collapse." 

Refrigerants. 

Refrigerants, of course, necessarily include all remedies 
which actually lower the bodily temperature, but the con- 
ventionally accepted meaning of the term merely implies 
anything which alleviates thirst. Thus we find that the 
mere sipping of any fluid moistens the dry tongue and les- 
sens the thirst of fever, whilst acids, by stimulating the 
secretion of saliva, may fulfil the same indication in a more 
scientific and effectual way. 

ANTISEPTICS AND DISINFECTANTS. 

Dr. Parkes proposed that the term disinfectant should be 
restricted to those substances which arrest the spread of spe- 
cific disease depending on the entrance into the body of a 
special agent ab externo, and that agents acting in other 
ways should be called air purifiers and sewage deodorants. 
It would seem well, however, to adhere in these pages to 
the nomenclature most commonly in use in our received 
text-books of Materia Medica, and, whilst willingly conced- 
ing the palm of scientific precision to Professor Parkes, I 
shall adopt the following division of the subject into disin- 
fectants and antiseptics. 

Disinfectants are those substances which act by destroy- 
ing offensive animal or vegetable effluences, arresting putre- 
faction, and stopping the spread of infectious and epidemic 
disease by destroying the particles on which the poison of 
these diseases is supposed to depend. How they do this is 
not matter of absolute certainty, but they act in many cases 
by direct chemical agency, by deoxidizing, or by taking up 
hydrogen and water ; and the theory of the modus operandi 
of various substances here enumerated will be considered 
when each of them comes separately under review. Adopt- 
ing, then, in some measure the nomenclature of Parkes, dis- 
infectants may be divided into — 

1. Air purifiers, which we may again subdivide into — 

(1) Solid air purifiers, of which charcoal is the best, also 
dried earth, quick-lime, etc. 



ANTISEPTICS AND DISINFECTANTS. 57 

(2) Liquid air purifiers ; Condy's fluid, zinc chloride, 
lead nitrate, and, 

(8) Gaseous air purifiers ; such as zinc, chlorine, iodine, 
bromine, nitrous acid, sulphurous acid, and carbolic acid. 

2. We may next include the sewage deodorants, of which 
charcoal, dry earth, as in Moule's patent system, iron per- 
chloride, quick-lime, potassic permanganate, carbolic acid, 
with the various powders, such as M'DougalPs and Calvert's, 
which are prepared from it, are the most prominent. 

3. Finally we have what Dr. Parkes calls disinfectants 
proper, which arrest contagious disease by destroying the 
particles of matter which pass away from the bodies of the 
sick. Of these heat is a valuable member, it being now well 
known that a dry heat, as of an oven at over 212°, will 
completely disinfect clothing. 

Chlorine is effectual, but irritating ; nitrous acid vapor 
has been recommended, carbolic acid is of undoubted ser- 
vice, but sulphate of iron seems to be of very doubtful utility. 

Antiseptics are those substances which arrest the spread 
of disease and decomposition generally, not by chemical 
action, but by a poisonous effect on the minute animal or 
vegetable germs on which these processes depend. It is 
therefore clear that they dovetail very essentially with the 
preceding group, more especially as it is difficult to draw 
a hard-and-fast line between those disinfectants which act 
chemically and those which arrest putrefaction and infective 
processes in other ways. The term antiseptic, therefore, is 
superfluous, and would probably have dropped altogether out 
of use had it not been for the term antiseptic surgery, which 
has been so extensively employed by Mr. Lister and his 
school, the theory being that putrefaction and pyaemia de- 
pend upon the presence of innumerable germs from which 
these substances free the air. 

The principal are carbolic acid, zinc chloride, boracic 
acid, salicylic acid, sulphurous acid, corrosive sublimate, and 
perchloride of iron. 

The term parasiticide has also been employed as indicat- 
ing those substances which specially act as poisons to the 
minuter animal or vegetable life, and are used medicinally 
with this view. Thus sulphurous acid and perchloride of 
mercury are used with success as local applications in various 
forms of parasitic skin disease, and sulphurous acid is bene- 
ficial in those cases of vomiting which depend on the irri- 



58 ASTRINGENTS AND CAUSTICS. 

tation of low forms of cryptogenic vegetation imbedded in 
the mucous glands of the stomach. 



[ASTRINGENTS AND CAUSTICS. 

The property of astringency, or ''puckering," is possessed 
by vegetable substances containing tannic acid and its deri- 
vatives ; and, on the other hand, by many mineral salts. 
Astringents generally possess the power of coagulating albu- 
men, but their therapeutic effect is rarely required to this 
extent ; in less degree of strength they excite a tendency to 
-Condensation or contraction of living organisms, partly, but 
not mainly, by local influence upon the unstriped muscular 
fibres. In a higher degree they generally act as irritants, or 
even caustics. When used to check bleeding they are 
termed styptics. Astringents find their greatest field of 
usefulness in a relaxed condition of mucous surfaces with ex- 
cessive follicular secretion. In cases of inflammation their 
tendency to exercise an irritant influence should not be lost 
sight of. 

Extremes of temperature such as are obtained by either 
hot or cold applications will check hemorrhage ; the cold 
acts as an astringent, but the heat more rapidly coagulates 
blood. 

The vegetable astringents are tannic and gallic acids, and 
their allied forms, as kino-tannic and catechu-tannic and 
gallo-tannic. Acetic acid and weak solutions of carbolic 
acid also are decidedly astringent. It may be that the effect 
of chrysophanic acid in psoriasis is largely due to an astrin- 
gent effect upon the vascular supply of the diseased skin. 

The principal mineral astringents are sulphuric acid and 
the soluble sulphates generally, particularly the ferrous and 
cupric sulphate ; but the soluble compounds of zinc, silver, 
lead, copper, cadmium, and aluminum are generally astrin- 
gent. The ferric salts with mineral acids, the ammonio- 
ferric sulphate, the calcic hydrate and carbonate, alum, sub- 
nitrate and subcarbonate of bismuth, and some of the volatile 
oils and resins are also to be included in the category. 

Caustics are used to destroy tissues, and belong more par- 
ticularly to surgery. When the application is mitigated or 
used in dilute solutions, the first effect of caustics, as a rule, 
is that of a stimulant and irritant, and they may exert an 



COUNTER-IRRITANTS. 59 

astringent effect. The principal agents used as caustics 
may be classified according to their action as follows : — 

CAUSTICS. 

PENETRATING. CIRCUMSCRIBED. 

Acetic acid. Dried alum. 

Bromine. Dried zinc sulphate. 

Chromic acid. Heat. 

Mercuric nitrate solution. Potassa with lime. 

Potassa. Silver nitrate. 

Sulphuric type-acids. Zinc chloride.] 



COUNTER-IRRITANTS. 

The theory of the action of epispastics and rubefacients 
has given rise to much interesting physiological speculation, 
but we are not yet able to lay clown, with absolute precision, 
the laws on which the beneficial action of these remedial 
agents depends. We know this much, however, that blis- 
ters may occasionally act locally on deeper seated parts, as 
we are told that redness and inflammation of pleura and 
peritoneum may be produced by the vesicating influence of 
cantharides applied to the cutaneous surface superficial to 
these structures. 

Then, again, vascular connection may explain other phe- 
nomena, and more especially may this be traced in the chest 
between the pericardial vessels and those of the skin imme- 
diately over the heart, and in the lumbar region between the 
superficial vascular supply and that which furnishes to the 
kidneys their due allowance of arterial blood. 

These more direct and obvious explanations of various 
interesting therapeutical phenomena do not, however, lead 
us very far, and we are compelled to fall back upon much 
more abstruse considerations. Into these neither our space 
nor the scope of the present volume will permit us to enter 
very far, and we only very briefly draw a slight outline of 
those branches of the question which seem to have reached 
something- of vigorous growth. 

Now for the relief of pain, counter-irritation may act, 1st, 
by removing or modifying the structural condition on which 
the reflected suffering depends, as we often cure a facial 
neuralgia by extracting a carious tooth ; or 2d, the end organs 
of the sensory nerves may be modified in molecular arrange- 



60 



DIAPHORETICS. 



merit ; or 3d, the trunks of the nerves themselves, or the 
nuclei or the nervous centres, may be altered in some unex- 
plained way by the stimulus applied to the seat of pain. 

For other purposes, also, counter-irritation may act by 
altering or re-distributing blood supply, as by actually empty- 
ing the deeper vessels and filling the more superficial arteri- 
oles at their expense ; or special function or nutrition may 
be profoundly affected by influencing the trophic or other 
nerves which more especially preside over these departments 
of the economy. 

The practical applications of counter-irritation in the 
treatment of disease are both numerous and interesting ; and 
when considering iodine, mustard, and_cantharides, we will 
devote some space to the consideration of the principles 
which should guide us to their successful use. 



DIAPHORETICS. 



This class of remedies has 
the property of increasing 
the secretions of the skin, 
and is usually divided into 
(1) the stimulating and (2) 
the sedative. Under the 
first heading we include 
those drugs which stimulate 
the cutaneous circulation, 
among the principal of which 
are ammonia, alcohol, the 
cold bath, phosphorus, etc. ; 
and, secondly, we speak of 
the sedative class, which act 
by dilating the superficial 
vessels, these being ipecac- 
uanha, tartar emetic, jabo- 
randi, aconite, the warm 
bath, and all the nauseating 
and emetic substances, the 
depressing action of which is 
invariably attended by free 
perspiration. Then again 
we must refer to what are 
known as adjuvant remedies, 



Diaphoretics are used 
freely in practice at the out- 
set of acute diseases, to relax 
the contracted vessels and 
relieve the hot, dry skin, and 
in pneumonia this line of 
treatment has produced good 
results. The sedative class 
would seem to be best adapt- 
ed for this purpose ; but the 
cold bath, which more natu- 
rally belongs to No. 1, has 
been freely used abroad in 
febrile disorders, and part of 
its beneficial effects must no 
doubt be due to its action on 
the skin. 

In eruptive fevers, when 
the eruption is not sufficiently 
developed, we endeavor to 
excite the function of the 
skin, and thus favor the local 
manifestation of the poison, 
by warm baths, wet-packing, 
and possibly by phosphorus. 



DIURETICS. 6L 

such as warmth to the sur- We also use diaphoretics to 
face, diluent drinks, etc. favor absorption, as in various 

dropsies, and to relieve the 
kidneys, between winch and 
the skin so much sympathy 
exists. 

They are also of service 
by assisting to eliminate mor- 
bid products from the blood. 
When the various internal 
organs, whose duty it is to 
get rid of certain effete and 
hurtful matters, are tempo- 
rarily or permanently off 
work, we may hope to sup- 
ply their place in some meas- 
ure by the skin, and in 
Bright's disease we may thus 
relieve the system of some 
urea; in jaundice, of biliary 
products, etc. 



DIURETICS. 

Diuretics stimulate and increase the flow of watery fluid 
through the kidneys in various ways, which we may conve- 
niently classify under the following headings : — 

Class 1. Stimulating diu- 1. These are cantharides, 

retics, which act by directly turpentine, colchicum, etc., 
exciting or irritating the but they are rarely thus used, 
glandular secreting structures as they are liable to produce 
of the kidney. pain, strangury, and even 

hemorrhage. Cantharides 
has, however, been recom- 
mended in some forms of 
chronic albuminuria and in 
pyelitis. 
Class 2. Those drugs which 2. The principal of these 
stimulate the circulation, are digitalis, belladonna, 
causing increased arterial squill, and ergot ; and they 
tension, and thus greater are of service in various drop- 
6 



62 



DIURETICS. 



pressure on the walls of the 
Malpighian bodies, by which 
means transudation of watery 
fluid is mechanically favored. 

Class 3. We next come to 
the saline diuretics, which, 
in addition to some slightly 
stimulating; influence, have a 
special power of absorbing 
and holding watery fluids, 
which they then carry with 
them in their exit from the 
body. 

Class 4. Mechanical diu- 
retics must next be included 
in the list, and among the 
principal of these we may 
mention w r ater, which acts 
by washing the urinary tu- 
bules clear from epithelium 
or casts, which block them 
under certain conditions, and 
so allowing secretion to be 
re-established. Under this 
heading we may also group 
those remedial means which 
act indirectly by relieving 
the kidneys in various ways. 
Thus, when congestion is 
present, local bleeding, dry 
cupping, warm fomentation, 
etc., may be the best diure- 
tics. When the kidneys are 
pressed upon .by ascitic fluid, 
a renewal of their full func- 
tion frequently follows the 
operation of tapping, and in 
many cases we may give 
these organs temporary rest 
by handing some part of 
their duties over to the skin 
or the bowels. 



sies, and perhaps most espe- 
cially in those which depend 
on disease of the heart. 

3. In this group we include 
the lithia, potash, and soda 
salts, and most of them pos- 
sess a double action, being 
diuretic in small, and purga- 
tive in large doses. They 
are also used with advantage 
in anasarca and dropsical ac- 
cumulations. 

4. Dr. Dickinson has shown 
how well copious draughts of 
water act in the acute de- 
squamative nephritis of chil- 
dren, on the mere mechanical 
principle of sluicing or wash- 
ing out the obstructed tu- 
bules. The indirect diuretics 
are often of most service in 
renal disease. 



EMETICS. 



63 



Diuretics are notoriously uncertain remedies, and many 
of them have not the slightest power of increasing the flow 
of urinary water during health. They also vary much in 
their power of promoting the elimination of urea and other 
products of excretion by the kidneys. They may be given 
either by the mouth or by vapor, in which way oil of juniper 
acts well; or, as in the case of digitalis, they may be effi- 
ciently used by cutaneous absorption. In their administra- 
tion we must observe the following rules: Give them freely 
diluted, and, as a rule, combined with one another, as several 
remedies of the class seem to act better than one, as in the 
famous Guy's pill. Keep the patient cool, so as to avoid 
any action on the skin, and endeavor to prevent the bowels 
from coming too freely into play. 

EMETICS. 

The object of an emetic is to stimulate the so-called 
vomiting centre in the medulla oblongata, close to the origin 
of the pneumogastric nerve, and induce it to call forth the 
complicated series of muscular acts which terminates in 
evacuation of the stomach. Emetics act in two ways, and 
are thus classed, as : — 



Direct. 

Where the drug irritates 
the filaments of the pneumo- 
gastric nerve distributed to 
the mucous membrane of the 
stomach, and this irritation, 
being transmitted to the cen- 
tre, is reflected in motor im- 
pulses through the pneumo- 
gastric, phrenic, and intercos- 
tal nerves. The direct emetics 
are prompt in their action, 
and cause little nausea and 
depression ; and the principal 
members are zinc sulphate, 
copper sulphate, ammonium 
carbonate, mustard, common 
salt, etc. 



Indirect. 

Emetics of this class are 
conveyed directly by the 
medium of the blood to the 
vomiting centre, and act well 
by injection without coming 
into contact with the stomach. 
They are less prompt and 
more depressing than those 
of the other class. Principal 
members : Ipecacuanha, tar- 
tarized antimony, apomor- 
phia, veratria, and delphinia. 



64 



EMETICS. 



The reflex chain then being established by which the 
muscular apparatus causes vomiting, we must next consider 
the various steps of the process. 



Physiology of Vomiting. 

1. In the first place the 
cardiac sphincter must be re- 
laxed, or no vomiting can 
take place, and the persistent 
contraction of this structure 
may account for many cases 
of distressing retching. 

2. The actual contraction 
of the walls of the stomach 
itself, must be supplemented 
by that of the abdominal 
parietes. 

3. The diaphragm descends 
and becomes fixed, so that 
the various muscles com- 
pressing the stomach act be- 
tween two fixed points. 

4. The glottis is closed. 

5. As vomiting cannot be 
effectually accomplished if 
the stomach is quite empty, 
under these circumstances 
the patient generally swal- 
lows a certain quantity of air, 
so as to distend the viscus. 



Therapeutics. 

Emetics are used to empty 
the stomach in cases of poison- 
ing, and here we invariably 
employ the direct class, such 
as the zinc sulphate, mustard, 
salt, etc. 

They are also of service in 
some forms of dyspepsia, and 
to clear the stomach in in- 
toxication, and for the relief 
of the convulsions of infancy, 
which often depend on irri- 
tating articles of diet. 

[Where the direct emetics 
are contra-indicated, we may 
resort to the indirect, which 
act by absorption. Emetia 
and apomorphia will cause 
vomiting if injected hypo- 
dermically.] 



1. Action on the Brain 
and Nervous System. — 
Emetics , may cause some 

.congestion of the brain by 
the obstructed venous return 
from the neck during the act 
of vomiting. 

2. Circulation and Respi- 
ration They have a seda- 
tive action on the heart- 
As the respiratory is close 



1. We must therefore avoid 
their use in apoplectic cases. 



2. Emetics are of great 
service in clearing the lungs 
in bronchitis, and in getting 
rid of the false membrane 



EMMENAGOGUES AND ECBOLICS. 



65 



to the vomiting centre, the 
breathing generally becomes 
sighing and irregular during 
the act of vomiting ; but in 
addition to this there is an 
increase of secretion from the 
pulmonary mucous mem- 
brane, and the compression 
of the lungs forces retained 
mucus out of the bronchial 
tubes. 

3. Organs of Secretion — 
By the pressure exerted on 
the intestines, some slight 
purgative action may result, 
and prolonged vomiting al- 
ways leads to the discharge 
of bile from the stomach by 
the mechanical squeezing of 
the liver and gall-bladder. 
Emetics invariably cause free 
perspiration during their ac- 
tion, as well as an increased 
flow of saliva. 



in croup and diphtheria, and 
they may thus be said to act 
as expectorants. We had 
here best use such emetics as 
ipecacuanha and tartarized 
antimony, which combine an 
expectorant action. 



3. Emetics may therefore 
be said to act as chola«;on;ues, 
and may be of great service 
in stimulating the action of 
the liver, and removing in- 
spissated secretions from the 
gall-bladder. Some authori- 
ties hold that it is good prac- 
tice to o-ive an emetic as 
early as possible at the outset 
of fevers, such as enteric ; 
and it has been suggested 
that the fever poison is re- 
tained at this stage in the 
bile, and may be expelled 
along with it from the system. 



EMMENAGOGUES AND ECBOLICS. 

Of these we may consider, first, 

Ecbolics. 



Pysiological Action. 

Ecbolics are substances 
which cause such violent 
contraction of the pregnant 
uterus as to effect the expul- 
sion of its contents. It is 
not quite certain whether 
the principal members of the 
group act specially on the 



6 : 



Therapeutical Action. 

Ecbolics are used exten- 
sively in obstetric practice 
when it becomes necessary to 
stimulate the flagging powers 
of an exhausted uterus — the 
principal being ergot, digi- 
talis, savin, borax, quinine. 
We are also compelled, under 



66 



EXPECTORANTS. 



muscular structures of the certain circumstances, to have 
organ, or whether a primary recourse to the induction of 
intervention of nervous in- premature labor, as when 
fluence through the spinal dangerous sickness goes on 
cord is necessary. unchecked, or when weak- 

ened abdominal or thoracic 
viscera are injuriously com- 
pressed by the pregnant ute- 
rus. In such cases, however, 
it is generally found best to 
use mechanical means. 



Emmenagogues 



May be direct or indirect. 

Physiological Action. 
Direct emmenagoories act 

© © 

merely by restoring the nor- 
mal functions of the uterus 
when these are suspended. 



Indirect emmenagogues act 
by removing some constitu- 
tional condition which inter- 
feres with the due perform- 
ance of the uterine functions. 
Thus amenorrhoea very fre- 
quently depends on anaemia, 
or constipation may require 
removal before our more spe- 
cial remedies will act. 



Therapeutical Action. 

Most of the ecbolic drugs 

act as enimena£0°ues when 

© © 

given in small doses to a non- 
pregnant patient, and to the 
list we may add rue and cas- 
tor. Of all these, however, 
ergot is by far the most ef- 
fectual. 

The different preparations 
of iron, in combination with 
aloetic or other purgatives, 
act well, and we may aid our 
chances of success by all hy- 
gienic means, as well as by 
warm hip-baths, leeches, and 
mustard stupes, at the normal 
menstrual periods. 



EXPECTORANTS. 

These are remedies which facilitate in various ways the 
expulsion of secretion from the bronchial tubes. They may 
thus be divided : — 



1. The emetic class, which 
are the most efficient of all, 



1. There can be no doubt 
that, when the lungs are 



EXPECTORANTS. 



6T 



removing and softening the 
mucus, causing the transuda- 
tion of watery fluids, and re- 
laxing the muscular walls of 
the bronchial tubes. 



2. Nauseants may also be 
of service as expectorants. 



3. We then have what are 
called the stimulating expec- 
torants, acting either on the 
general vascular system, or 
specially on the nervous and 
muscular structures of the 
lungs. 



4. Those remedies which 
promote secretion from a dry 
and swollen mucous mem- 
brane. 



5. Expectoration is often 
rendered difficult by tena- 
city of the mucus, which is 
coughed up, only after much 
straining and effort, and great 
relief follows every drug which 



choked with secretion, a good 
emetic often acts like a charm, 
as in bronchitis, whooping- 
cough, etc. 

We must here use the in- 
direct emetic agents, as am. 
carb., ipecacuanha, etc. 

2. These are merely the 
indirect emetic drugs given 
in small doses, as antimony, 
ipecacuanha, etc. 

3. These are senega, am. 
carb., etc. ; but it is evident 
that any tonic or stimulating 
remedy may frequently act 
indirectly as an expectorant, 
by improving the tone of the 
circulation, and giving the 
patient strength to cough and 
clear his lungs. The stimu- 
lating expectorants are more 
especially used in the later 
stages of pulmonary disease. 

4. In the earlier stages of 
bronchitis much discomfort 
occurs from the dry hard 
cough and difficulty of breath- 
ing arising from swelling of 
the bronchial mucous lining. 
Great relief is experienced 
when free expectoration is 
established, and this may be 
promoted by inhalation of 
steam, liq. ammonii acet., lo- 
belia, and the class of nause- 
ants generally. 

5. We find that alkalies act 
w r ell here, and, if any gouty 
tendency exists, more espe- 
cially potassic iodide. 



68 



NARCOTICS AND ANODYNES. 



can thin or liquefy the secre- 
tion. 

6. Spasmodic contraction 
of the smaller bronchial tubes 
may interfere with free ex- 
pectoration. 



6. Here we may hope to 
obtain relief by the use of 
opium, belladonna, stramoni- 
um, tobacco, etc. 



NARCOTICS AND ANODYNES. 

Narcotics, as the name implies, are those remedies which 
cause sleep, and they do so by imitating the normal physio- 
logical arrangement of that condition, and producing an anae- 
mic state of the cerebral hemispheres. Why they act in this 
selective way on the brain is not very clear ; for although 
opium contracts the bloodvessels, thus arresting nearly all 
secretion, chloral has a dilating effect, and pot. bromid. has 
not been proved to have any special action on the circulation 
at all. Bernard's theory of independent vascular areas acted 
on by special drugs only removes the difficulty further back, 
as, of course, we are totally unable to explain why one drug 
affects one region or function, and another another. But 
whatever the explanation may be, we all gratefully acknow- 
ledge the enormous benefits derived from the control over the 
reparative process of sleep these remedies afford us, and a 
reasonable mode of division seems to be into — 1st, direct nar- 
cotics ; 2d, indirect narcotics. 



1. Direct Narcotics. 



Physiological. 

These are the following 
drugs, named in their order 
of potency, as opium, chloral 
hydrate, potassium bromide, 
hyoscyamus, belladonna, hop, 
and Indian hemp. The pe- 
culiar action of chloral, how- 
ever, occasionally causes its 
failure in cases of debility, 
where it acts by increasing 
the natural tendency of the 
relaxed arteries to dilate, thus 



Therapeutical. 

Opium is, beyond doubt, 
the most potent and certain, 
and, perhaps, least dangerous 
narcotic ; but the digestive 
disturbance unhappily follow- 
ing its use often interferes 
with its continued adminis- 
tration. It is, no doubt, best 
adapted of all the remedies of 
this class for use in fevers and 
in all painful conditions, on 
account of its anodyne pro- 



NARCOTICS AND ANODYNES. 



69 



flushing the brain with blood 
during recumbency, effectu- 
ally preventing sleep. 



perties. Chloral is more to 
be recommended in simple 
insomnia, in delirium tre- 
mens, and in all cases where 
we wish to keep up a pro- 
longed narcotic effect, as it is 
not requisite, as a general 
rule, to increase the dose. 
Bromide of potassium is well 
adapted to soothe the system, 
when once excited by worry 
or over- work, and the others 
are occasionally useful when 
success has not been attained 
by other means. 



2. Indirect Narcotics. 



Physiological. 

First on this list we must 
place those drugs which sec- 
ondarily affect the brain cir- 
culation by toning up the ar- 
teries, and thus regulating the 
supply of blood. Digitalis is 
here all-important ; and iron, 
also, has its place, by improv- 
ing the quality of the blood. 
A little alcohol, given at the 
right time, will often produce 
sleep ; and it is well known 
that the state of exhaustion 
produced by an empty sto- 
mach will often lead to pro- 
longed wakefulness, only to 
be removed by a little food. 



Darkness and quiet, and 
warmth, promote slumber, and 
the opposite condition of cold 
is well known to cause a co- 
matose condition, too often 



Therapeutical. 

Digitalis often acts very 
efficiently, as a narcotic, by 
removing that relaxed condi- 
tion of vessel which substi- 
tutes congestion for anaemia, 
when the patient lies down ; 
a little alcohol at bed-time, 
more especially for the aged, 
is an excellent " night cap," 
and when we find weakly 
persons complaining of want 
of sleep, we will do well to 
order a cup of milk or a little 
beef-tea, or other simple nour- 
ishment, to be taken at bed- 
time, or placed by the bed- 
side for use in the early morn- 
ing hours, when the power of 
life beo-ins to flag. 

Suitable bed-room arrange- 
ments are very important, as 
some persons are at once 
awakened by the faintest ray 
of light. Some like a hard 



70 



PURGATIVES. 



ending in death. Sleep, again, 
is promoted by the removal 
of everything which prevents 
it. 

Thus, hyoscyamus or conia, 
or atropia, by stilling the wild 
ravings of mania, may be 
truly narcotic, and the next 
class of remedies are often ef- 
fective members of the major 
group, by lulling or removing 
pain, which made sleep im- 
possible. 

Anodynes. 



bed, others, a soft ; according 
to their personal habits. 



These drugs have done 
good service in asylum prac- 
tice. 



Physiological. 

Anodynes act by lulling 
pain, probably by interfering 
with the conducting power of 
sensory nerves. Opium pos- 
sesses this power, which is 
absent in chloral, and then 
we have aconite, belladonna, 
chloroform, etc., which may 
soothe locally, as well as con- 
stitutionally. 



Therapeutical. 

Of all anodynes opium is 
the best, and more especially 
morphia by subcutaneous in- 
jection, which rarely fails to 
lessen, and often speedily re- 
moves pain, chloral only re- 
moves pain during sleep, but 
curare is probably a true se- 
dative. Local application of 
anodynes is only serviceable 
in acute inflammation, neu- 



PURGATIVES. 

Purgatives may be divided, first, into two classes depend- 
ing on their origin, and these are : — 

1. The inorganic substances, comprising chiefly the mer- 
curials and salines. 

2. Those derived from the vegetable kingdom, and which 
depend for their therapeutical action on the presence of resins 
or oils. 

Their actual modes of operation, however, are much more 
varied, and they will best be considered by division under 
various headings, according to their physiological and thera- 
peutical properties. 



PURGATIVES. 



U 



1 . Laxatives. — These sub- 
stances act by causing a slight 
increase in the peristaltic 
movement of the intestines, 
with softening of the feces, 
which are then expelled in a 
solid and formed condition. 



2. Purgatives produce 
more decided effects both in 
stimulating movement and 
secretion ; but is difficult to 
separate them entirely from 
either class No. 1 or No. 3. 



3. Drastic Purgatives. — 
These run by insensible gra- 
dations into the preceding 
class. Their action depends 
on an irritation of the mu- 
cous membrane of the intes- 
tines, and not only an actual 
increase of secretion from 
their glands, but the with- 
drawal of watery fluids from 
the blood. An overdose, 
therefore, may be attended 
by serious depression, discom- 
fort, and even by death from 
inflammation of the bowel. 



1. The principal of these 
are sulphur, castor-oil, mag- 
nesia, etc. ; but in addition 
to actual drugs we may in- 
clude various articles of diet, 
as oatmeal, brown bread, 
whole flour, figs, prunes, etc., 
which act purely mechani- 
cally. 

Laxatives are useful when- 
ever we desire a mild and un- 
irritating effect, as in simple 
constipation from dyspepsia, 
pregnancy, or convalescence 
from acute diseases, seden- 
tary habit, and other causes. 

Castor-oil acts well in the 
early stages of diarrhoea, by 
sweeping away the irritating 
cause. 

2. Rhubarb, senna, aloes, 
and jalap are reckoned among 
the chief of these, and they 
are used in various dyspep- 
tic conditions, rhubarb being 
more especially stomachic, 
and aloes emmenagogue, in 
their properties. 

3. In this class we include 
jalap, scammony, colocynth, 
gamboge, and croton oil, and 
they are principally used 
either in obstinate constipa- 
tion, or to produce a deriva- 
tive or species of counter-irri- 
tant effect in various forms of 
brain disease. 



72 



PURGATIVES. 



4. Hydragogue -purgatives 
cause very free secretion from 
the mucous membrane of the 
bowels, and empty the veins 
by withdrawing fluids from 
the blood. 



5. Saline Purgatives 

We shall, when treating- of 
magnesium sulphate (Epsom 
salt), consider the action of 
this class, and point out 
how, from their low diffusive 
power, they pass with difficulty 
into the blood, and how, 
whilst in the intestine, they 
not only absorb, retain, and 
carry away the watery fluids 
which they find in the intes- 
tine, but also directly with- 
draw fresh supplies from the 
blood itself. 

6. CJiolagogue Purgatives. 
— Much experiment has re- 
cently been expended on the 
action of this class, and those 
recently conducted on im- 
proved principles by Prof. 
Rutherford have given us 
very precise and reliable in- 
dications for practice. Cho- 
lagogues act either by directly 
stimulating the secretion of 
the bile, or by contracting the 
gall-bladder and irritating the 
duodenum, so as to sweep the 
bile out of the intestine as 
fast as it is poured in by the 
hepatic ducts. 

In addition to drugs be- 
longing to the actual purga- 
tive class, we have many 
indirect remedies which act 



4. These are elaterium, 
cream of tartar, etc., and they 
are most useful in ascites and 
other dropsical conditions, 
and for the relief of a feeble 
and laboring heart by dimin- 
ishing the actual volume of 
the blood. 

5. Sulphate of magnesia 
and many of the salts of pot- 
ash and soda must here be in- 
cluded. They are best given 
in a state of free dilution, and 
make very efficient habitual 
purgatives, more especially in 
the form of various natural 
purgative waters, such as 
Friedrichshall, Pullna, and 
Congress water. 



6. The principal members 
of this group are mercury, 
podophyllin, rhubarb, aloes, 
jalap, etc. They are used for 
the relief of various functional 
affections of the liver, to re- 
move what is commonly 
known as u biliousness," and 
to obviate portal congestion. 



Among the stimulating 
class we may mention 
strychnia, nux vomica, er- 
got, and the ferrous sulphate, 



STIMULANTS AND SEDATIVES. 



73 



with considerable efficiency. 
Thus we may use enemata, 
cold to the abdomen, me- 
chanical kneading of the 
parietes, electricity ; we may 
stimulate the muscular tis- 
sues to contraction ; or we 
may cause a purgative action 
by relieving spasm. 



and these are very efficient, 
in combination with mild 
purgatives, where constipa- 
tion depends on a lax or 
weakened state of the in- 
testinal walls. 

When spasm or irregular 
contraction prevents free 
action of the bowels, we 
must have recourse to opium, 
belladonna, or the lead ace- 
tate, which, under these con- 
ditions, may be looked upon 
as true cathartics. 



In administering purgatives, we must consider the various 
parts of the intestinal canal on which they act. Thus senna, 
jalap, etc., act on the small intestine, aloes on the large, 
podophyllin on the duodenum, etc. We must also consider 
the time of their administration, as we find that the slowly 
acting resinoid substances are best given at night or before 
dinner, whereas the salines are best taken on an empty sto- 
mach, and more especially before breakfast. The mode of 
administration is also worthy of note, the resinoids being 
best taken in the form of pill, whereas the salines act best 
in solution with free dilution and in combination with bitters, 
iron, or sulphuric acid. 

STIMULANTS AND SEDATIVES. , 



Stimulants and sedatives are so directly antagonistic in 
nature that the most satisfactory scheme of their action will 
be presented by direct contrast in parallel columns, according 
to the plan adopted generally throughout these pages. 



I. General Stimulants. 

As the principal members 
of this group we may mention 
alcohol, opium, and the an- 
aesthetic vapors, which, whilst 



stimulant ] 
cotic in 

7 



small, 



are 



large 



dosec 



nar- 
the 



I. General Sedatives. 

The stimulating drugs in 
the opposite column, when 
carried beyond a certain 
point, cause a sedative or 
soothing action, and run by 
insensible degrees into the 



u 



STIMULANTS AND SEDATIVES. 



ethers and ammonia, which truly narcotic class of reme- 
are called diffusible because dies. Over-stimulation pro- 
rapid elimination prevents duces exhaustion and indi- 
any marked display of their rectly a sedative action, 
stupefying qualities. We 
may refer to the article on 
alcohol for directions as to 
the use of stimulants in 
health and disease. Then 
again, the cold douche, coun- 
ter-irritation, and electricity 
may act as powerful stimu- 
lating agents under certain 
conditions. 



II. Special Stimulants. 

1. To the- nervous system. 
Alcohol, ether, and opium un- 
doubtedly stimulate the brain, 
causing greater intellectual 
activity and an increased flow 
of ideas, occasionally some- 
what irregular in form. 
Phosphorus may be ranked 
under this heading, and digi- 
talis may improve the func- 
tions of the cerebral hemis- 
pheres by the more regular 
supply of blood which its 
tonic influence on the arterial 
system provides. 

The spinal cord is directly 
and powerfully stimulated by 
strychnia, and in the lower 
animals by morphia; whilst 
ergot and belladonna, by con- 
tracting its vessels, may help 
in removing various condi- 
tions of debility. Certain 
nervous centres are stimu- 
lated by certain drugs. Thus, 
atropia stimulates the respi- 



II. Special Sedatives. 

1. Nervous system. The 
.best sedatives to the brain 
are undoubtedly those drugs 
which diminish its blood sup- 
ply and so cause sleep. Co- 
nium is held to exert a spe- 
cially sedative effect on the 
great motor ganglia. 



The principal spinal seda- 
tives are Calabar bean, bro- 
mide of potassium, chloral, me- 
thyl conia, and gelseminum, 
which powerfully depress the 
reflex functions of the cord. 

The respiratory centre is 
depressed by chloral hydrate, 
hydrocyanic acid, amyl ni- 
trite, aconite, opium, etc. 

An interesting selective ac- 



TONICS. 



15 



ratory centre, the indirect 
emetics stimulate the vomit- 
ing centre, strychnia the vaso- 
motor centre, etc. The ear- 
ringing property of quinine 
is probably due to an irrita- 
tive action on the auditory 
nerve, digitalis stimulates the 
vagus, whilst jaborandi and 
muscarin confine that action 
to the intra- cardiac inhibitory 
apparatus. The sialagogue 
action of jaborandi is be- 
lieved to be due to a stimu- 
lation of the periphery of the 
salivary nerves. 

2. Cardiac and Vascular 
Stimulants. The general 
stimulants already enumerat- 
ed undoubtedly stimulate the 
heart, and the class of drugs 
of which digitalis is the type 
have been already considered 
under cardiac tonics. Opium 
is decidedly a vascular stimu- 
lant. 

3. Digestive and Secretory 
Stimulants. The stomach 
may be stimulated by ginger, 
capsicum, pepper, and the 
like ; whilst cholagogues, diu- 
retics, purgatives, and dia- 
phoretics may be held to 
stimulate the liver, kidneys, 
intestines, and skin, by pro- 
moting or exciting their re- 
spective functions. 



TONICS. 

Tlie word tonic is undoubtedly vague from the strictly 
scientific stand-point, but we may congratulate ourselves that 
zeal for more precise nomenclature has not yet succeeded in 



tion of a sedative or paralyz- 
ing nature is exerted by the 

following; drugs on the fol- 

© © 

lowing nerves. Atropia para- 
lyzes the intra-cardiac inhib- 
itory apparatus and the ter- 
minal fibres supplied by the 
third nerve to the iris. Co- 
nium paralyzes the third 
nerve, gelseminum the sixth, 
and croton chloral the fifth, 
Atropia also exerts an inhib- 
iting influence upon the se- 
cretory nerves of the sub- 
maxillary gland, etc. 

2. Cardiac Sedatives. The 
principal cardiac sedatives or 
depressants are aconite, to- 
bacco, colchicum, chloral, 
chloroform, and potassium 
nitrate. 



3. Digestive and Secretory 
Sedatives. A sedative ac- 
tion on the stomach may be 
produced by hydrocyanic 
acid, bismuth, and alkalies, 
generally in small dose. 



76 TONICS. 

depriving us of a term which has now included so many asso- 
ciations of an empirical kind. The best example of tone 
probably is the gentle and permanent contraction of the mus- 
cular tissue, which is kept up in the healthy body by the 
central nervous system, and which, when suspended by dis- 
ease, is familiar to us all in the flaccid and powerless limb of 
paralysis, and an appropriate remedy is found in electricity, 
which improves the nutrition and status of the part. We have 
vascular tone also, in which the due calibre of the arteries is 
regulated by the action of the vaso-motor nerves, and were 
we asked to name two tonic remedies which reinforce these 
important functions, we might unhesitatingly point to strych- 
nia, which aids the nervous tone, and digitalis, which raises 
the arterial tension by stimulating the vaso-motor centre. 
But treating our heading in a more general sense, we are 
^justified in calling anything a tonic which improves the gen- 
eral health, and thus an emetic, or a purgative, or a nar- 
cotic, or a sedative, may really have tonic properties by 
removing obstruction or irritation and givinc; rest to fatigued 
or worn-out organs. The best of all tonics, after all, are 
those which cannot well be included in any therapeutical 
tables ; for what can equal the bracing properties of sea- 
bathing, of change of air and scene, of the keen whiff of 
exhilarating ozone on a Swiss glacier or a Scotch moor, of a 
day's hunting or shooting, or a ramble along a good trout 
stream w r hen fish are Avell on the take ? A good dinner, 
with a glass of good wine, cheerful society, the stimulus of 
hope, even the rousing effect of a sudden reverse of fortune, 
may be often more successful than mere drugs ; but in con- 
sidering the varying modes of treatment, for debility in its 
many forms, we may usefully divide our therapeutic resources 
in the following way : — 

I. Nervine Tonics. 

Physiological. Therapeutical. 

1. First among these we 1. Under certain condi- 

may rank agents acting di- tions of mental excitement 
rectly on the brain, reducing or worry or debility, no tonic 
its blood supply and giving can be so good as a sound 
it rest. night's rest, and the narcotic 

class of remedies act well by 
supplying this. 



TONICS. 



11 



2. Then again, certain 
drugs act on special centres ; 
thus, strychnia and digitalis 
stimulate the vaso-motor cen- 
tre, atropia the respiratory 
centre ; and strychnia stimu- 
lates the spinal cord. 

Finally, we have those 
substances generally known 
under the somewhat vague 
title of nervine tonics. These 
are principally metals, such 
as arsenic, phosphorus, zinc 
oxide, and zinc sulphate ; but 
quinine and ammonium chlo- 
ride have also good right to 
be included in the list. 



2. Strychnia and nux vom- 
ica are of great service by 
aiding the circulation through 
the vaso-motor centre, and 
helping the spinal cord to re- 
sume its full functions when 
it is weakened by any debili- 
tating cause. The nervine 
tonics are used not only in 
simple debility, but in spe- 
cial conditions of nervous 
weakness. Thus quinine, 
arsenic, and even ammonium 
chloride are of service in neu- 
ralgia, probably by giving in- 
creased tone to sensory nerves; 
the zinc salts are useful in the 
irregular muscular contrac- 
tions of chorea, and in the 
loss of the presiding nervous 
control which characterizes 
hysteria. 



II. Vascular Tonics. 



This class of remedies may 
act in three different ways. 

1. On the heart itself, 
bracing up and improving 
the condition of tone of its 
muscular fibre and slowing 
its action so as to give it in- 
creased rest. Digitalis stands 
first on the list. 

2. Those which act more 
particularly on the vessels, 
raising arterial tension by 
contracting the muscular tis- 
sue of which their walls are 
largely composed. Here 
again digitalis comes into 



1. We see the great bene 
fit of this division more espe- 
cially in heart disease, where 
the pulse is feeble and irregu- 
lar, and in functional derange- 
ment of cardiac action from 
feebleness of the muscular 
structures of the heart. 

2. These also act well in 
improving the general tone 
of local circulation, bracing 
up the vessels, and removing 
oedema and passive conges- 
tion. 



7* 



78 



TONICS. 



play, but we also have ergot, 
belladonna, etc. etc. 

3. Those which act di- 
rectly on the blood, increasing 
the number of red corpuscles 
and the amount of hamiosrlo- 
bin which they contain. Iron, 
phosphorus, arsenic, and cod- 
liver oil have been proved, 
by careful investigations and 
by direct measurement, to 
have this property. 



3. In anaemia, where the 
blood is poor in red corpus- 
cles and haemoglobin, in chlo- 
rosis, in the debility follow- 
ing loss of blood, etc. etc., 
these hsematinic remedies, 
as they have been called, are 
of essential service, whilst in 
neuralgia they act well by 
giving the enfeebled sensory 
nerves the healthy stimulus 
of better blood. 



III. Digestive Tonics. 



Of the importance of this 
division there can be no doubt, 
when we consider that life 
itself, as well as sound health, 
depend on the consumption 
and due assimilation of a 
well-arranged dietary. Bit- 
ters are generally looked 
upon as the type of tonics, 
and there is no doubt that 
they increase the feeling of 
appetite and augment the 
secretion of saliva, and .possi- 
bly that of the gastric juice. 

Then, again, the best tonic 
to an irritable stomach may 
be remedies such as bismuth 
and hydrocyanic acid, which 
calm and soothe, and enable 
the mucous membrane to re- 
sume its function. Gentle 
purgatives may also act as 
tonics, and acids and alkalies, 
which both check inordinate 
acid secretion and encourage 
its flow. 



In general debility and 
feebleness, convalescence 
from acute illness, and want 
of tone, we know how much 
more hopeful we become 
when our patient is able to 
relish and digest his food, 
and we also know how great 
is the aid given by small 
doses of alcohol with the 
meals, in helping the weak 
stomach to do its work. For 
irritable dyspepsia, with a 
red tongue, the ordinary 
tonics only do harm, and 
when the tongue is foul and 
loaded, a mild course of pur- 
gatives will remove unhealthy 
mucus and enable digestion 
to be satisfactorily accom- 
plished. 



ACTION OF THERAPEUTIC AGENTS. 



19 



[SUMMARY OF THE ACTION OF THERAPEUTIC 

AGENTS. 



Remedies may be used with a therapeutic effect for the 
purpose of favorably modifying : — 

Environment (Antiseptics, and hygienic influences). 

Food. 
Appetite. 
Digestion. 
Absorption. 
Nutrition -^ Secretion. 

Blood-crasis. 
Respiration. 
Bodily heat. 
Organic status. 

[ Sensation (general and special). 
Innervation ^ Motility. 

[_ Condition of nervous structure. 



Circulation <{ 



A , . c n ( Stimulant. 

Action or heart -< , . 

( Sedative. 

Arterial contraction. 



[ Volume of blood. 



Functional 

activity 

(specifically). 



Stomach. 
Liver. 
Kidneys. 
Heart. 
Lungs. 

Nervous struc 
tures, etc. 



Vomiting. 
[ Purging. 
Counter-irritation, etc. 



They also indirectly influence development, and in an 
unknown manner act upon certain morbid states, as cin- 
chona in malaria, and mercury in syphilitic dyscrasia. 

The following classification (essentially that of Dr. H. C. 
Wood) will probably be found to be as useful as any that 
has been offered : — 



80 



CLASSIFICATION OF DRUGS. 



CLINICO-PHYSIOLOGICAL CLASSIFICATION 
OF DRUGS. 1 

I. Local, or Non-systemic Remedies. 
Anthelmintics. 
Chemical antidotes. 

(" Absorbing. 

Disinfectants 



1 



Stomachics 



Antizymotic. 

Dehydrating. 

Oxidizing. 

Antacids. 

Carminatives. 

Dijyestants. 



II. Substances which act on the solids and fluids of the body. 
a. Systemic Remedies. 
Class I. Astringents. 
II. Tonics. 

III. Cardiac stimulants. 

IV. Cardiac sedatives. 

V. Antispasmodics, f Nervines. 
VI. Analgesics. 
VII. Mydriatics. 
VIII. Anaesthetics. 
IX. Excito-motors. 

X. Depresso-motors. 
XI. Alteratives. 



<( Anodynes. 
I Hypnotics. 



Special stimulants 
and sedatives. 



b. Organic 


Remedies. 






Class I. 


Emetics. 


Class IX. 


Errhines. 


II. 


Cathartics. 


X. 


Epispastics. 


III. 


Diuretics. 


XI. 


Rubefacients. 


IV. 


Diaphoretics. 


XII. 


Escharotics. 


V. 


Expectorants. 


XIII. 


Demulcents. 


VI. 


Emmenagogues. 


XIV. 


Emollients. 


VII. 


Oxytocics. 


XV. 


Diluents. 


VIII. 


Sialagogues. 


XVI. 


Protectives.] 



1 [The student will find it good practice to copy this table on a 
sheet of paper, and afterwards insert the various drugs under their 
proper headings in accordance with the description of their effects 
given in the following pages. In discussing the remedies systema- 
tically in this work, it has been thought best not to follow any 
therapeutical classification, as none that have been offered are free 
from objection, and the advantages of an alphabetical arrangement 
for the convenience of reference are too obvious to demand dis- 
cussion.] 



REMEDIES 



COMPRISED IN THE 



PRIMARY LIST OF THE UNITED STATES 
PHARMACOPEIA. 



ABSINTHIUM— WORMWOOD. 

[ The tops and leaves of Artemisia Absinthium, U. S.~\ 

Wormwood was formerly used as a bitter tonic and an- 
thelmintic, but it has now quite disappeared from practice. 
Its prolonged use as a beverage, in the form of liquor, has 
been shown to produce a condition of enfeeblement and 
irritability of the nervous system, with a tendency to epi- 
leptiform convulsions. 

[In combination with other herbs, it is occasionally used 
in domestic practice under the name of German Tea as a 
tonic ; and in the form of infusion it is sometimes given for 
intestinal worms in children. Wormwood entered into the 
composition of the once famous "thieves' vinegar," Vinaigre 
des quatre voleurs (JSTysten, Diet, de Med.). The plant con- 
tains a volatile oil, which gives name and flavor to absinthe.^ 



ACACIA—GUM ARABIC. 

\_A gummy exudation from Acacia vera and other species 
of Acacia, U. S. 

Officinal Preparations, U. S. 

Syrupus Aeaeiae, used as a vehicle. 
Mueilago Aeaeiae, used as a vehicle. 

Also enters into Mistura Amygdala3, Mistura Cretse, and 
Mistura Glycyrrhiza3 Composita, 1 and is used as an excipient 
and dusting-powder for pills.] 

1 [Commonly called Brown Mixture.] 



82 VINEGAR ACETIC ACID. 

Gum is demulcent, and in the form of mucilage is much 
used for the suspension of bulky and insoluble powders, as 
well as to prevent the precipitation of the resin, which en- 
sues when such substances as tincture of myrrh, tinct. can- 
nabis Indicae, etc., are added to water. 

[Gum- Arabic water may be given as a demulcent drink 
in fevers, in angina, in g astro-enteric inflammation, and 
dysentery. It has some slight nutritive properties.] 



[ACETUM— VINEGAR. 

Impure dilute acetic acid prepared by fermentation, U. S. 

Officinal Preparations, U. S. 

Aeetum Destillatum, used in making Tinctura Opii 
Acetata. 

External and Internal Uses. 

Vinegar, more or less diluted, is a favorite domestic appli- 
cation in headache, sprains or bruises, and sun-burn ; it is 
also used as a clyster against ascarides. It may be given as 
a refrigerant drink in fevers ; and in these cases it is fre- 
quently applied to the surface of the body, with a sponge, as 
a means of reducing high temperature. In small amounts 
vinegar aids digestion, but in excess produces degeneration 
of the gastric tubules and thickening of the coats of the sto- 
mach. It is supposed to act on the blood by influencing its 
crasis, and reducing the proportion of fibrin. It has been 
found an efficient remedy in scurvy, in combination with 
nitre (^j to Oj), of which an ounce may be given four times 
daily.] 



ACIDUM ACETICUM— ACETIC ACID. 

[Acetic acid of specific gravity 1.047, U. S. 
Officinal Preparations, U. S. 

Acidum Aeeticum Dilutum (fgij in Oj). Dose 
f3J-ij (4 to 8 gm.). 

Also enters into Aeetum Lobelia?, Aeetum Opii, Aeetum 
Sanguinariae, Aeetum Scillas (Syrupus Scillae), Emplastrum 
Ammoniaci, Extractum Colchici Aeeticum, Extractum 



ACETIC ACID. 83 

Ergotse Fluidum, Liquor Ammonii Acetatis, Syrupus Allii, 
Potassii Acetas, and Zinci Acetas. 

Symptoms of Poisoning. 

Great heat and burning pain in the stomach, vomiting a 
sour liquid, purging, convulsions, coma, and death. 

Mouth and fauces brownish, lingual papillae swollen, 
sloughing of mucous membrane of pharynx, stomach livid 
or blackened, capillaries injected. 

Antidotes. 

In poisoning by acetic acid, alkalies or their carbonates 
may be given, properly diluted, and vomiting encouraged by 
large draughts of warm water containing soap.] 

External Action. 

Strong, or glacial, acetic acid is a favorite and very suc- 
cessful application to ivarty growths, whether of venereal 
origin or not. The little tumor is touched several times 
with a glass rod, or brush, or a piece of wood dipped in the 
acid, care being taken that none of the fluid trickles down 
over the neighboring structures. A few repetitions of this 
process will generally prove effectual. It is also topically 
used in some obstinate forms of skin disease, and more espe- 
cially the varieties of tinea comprised under the term ring- 
worm. The acid probably acts by directly attacking and 
destroying the parasitic growth on which the troublesome 
affections depend. Acetic acid is also occasionally applied 
to corns. 

Another mode of local use w r as proposed by Dr. Broad- 
bent some years ago, and strong hopes were then entertained 
that a remedy had been at last found for cancer. Observing 
the destructive influence of the acid on cancer elements out 
of the body, Dr. Broadbent very reasonably expected, that a 
similar effect might be produced within the living organism, 
and advised the injection of diluted acetic acid into the sub- 
stance of the cancerous mass. Some evidence seemed to be 
adduced in its favor, but its action being painful, tedious, and 
uncertain, the process has now fallen into perhaps unmerited 
oblivion. 



84 CARBOLIC ACID. 



Internal Use. 

Acetic acid is seldom used internally, although it forms 
an agreeable and effectual remedy for the checking of night 
sweats, and Graves used thus to prescribe it. 

The varieties of acetic acid are : Acidum aceticum, from 
which are prepared acidum aceticum dilutum and oxymel, 
the doses being of acid. acet. dil. f'5j to f3ij (4 to 8 gm.), 
oxymel [Br.] f'5j to f'3ij (4 to 8 gm.); and acidum aceticum 
glaciale. Then we have vinegar, the strength of which cor- 
responds pretty accurately with the dilute acid, and which 
is purely a domestic remedy for headache, hysteria, and 
other allied conditions. 



[Aceta. 

Acetum Destillatum. Acetum SanguinariBe. 

" Lobelia?. " Scillse.] 

" Opii. 



ACIDUM ARSENIOSUM— ARSEN10US ACID. 

[Sublimed arsenious acid in masses, U. S. See ARSENIC] 



[ACIDUM CARBOLICUM IMPURUM. 

Impure carbolic acid, U. S. Used only as an external remedy or for 
disinfecting purposes.'] 



ACIDUM CARBOLICUM— CARBOLIC ACID. 

[A solid substance obtained from the products of the distillation of coal- 
tar, between the temperatures of 300° and 400°, U. S. 

Dose, gtt. i— ij (=0.06 gm.), in pill or solution. 

Officinal Preparations, U. S. 

Glyceritum Aeidi Carboliei. (Acid 31J by weight, 
glycerin half a pint.) Dose ni > v--x (=.30 to .60 gm.). 

Unguentum Aeidi Carboliei (3j to 3J). 

Suppositoria Aeidi Carboliei (each gr. j). 

Aqua Aeidi Carboliei. (Glycerite of carbolic acid 
f3x, water q. s. to Oj.) 



CARBOLIC ACID. 



85 



Poisoning. 

In poisonous doses it causes burning and pain in the stom- 
ach, mucous vomiting, clammy, cool skin, difficult breathing, 
insensibility, contracted pupils, collapse, and death. 

Antidotes. 

Saccharate of calcium, calcium carbonate, and calcined 
magnesia in lime-water, are probably the best antidotes. 
Alkalies, soap, or the fixed oils may be given, with demul- 
cent drinks, and the stomach evacuated with a pump or 
siphon, as the local effect of the acid will generally prevent 
emetics from acting.] 



Local Action. 



Physiological Effects. 

Carbolic acid is, in the 
first place, an antiseptic, from 
its power of destroying the 
minuter forms of animal and 
vegetable life. 



Carbolic acid is an irri- 
tating substance, and, if ap- 
plied sufficiently long to the 
skin, will cause sloughing. 

It has, however, undoubted 
ansesthetic properties. 



Therapeutical. 

It is therefore much used 
as an antiseptic and deodor- 
ant for the treatment of ill- 
smelling drains, etc., or to 
destroy the infectious pro- 
perties of various secretions 
or discharges from the sick. 
It may also be useful as an 
injection or lotion to foul 
sores. 

Although carbolic acid 
may be of use in correcting 
fetor, it is too irritating to 
make a good lotion for 
wounds or ulcers [unless pro- 
perly diluted, with oil (1 in 
24) or water (3j to _ Oj), 
when it forms an admirable 
dressing]. It has been used 
as a caustic in some ulcera- 
tive affections, as lupus. It 
has been recommended as 
a local anaesthetic during 
small operations, and to dead- 
en the pain of some caustic 
applications. [The pain of 



86 CARBOLIC ACID. 

opening a felon may be great- 
ly reduced by previously im- 
mersing the finger for a few 
minutes in a 3 to 5 per cent, 
solution of carbolic acid.] 
It is a good application in 
tinea tonsurans, both de- 
stroying the microspores and 
preventing their develop- 
ment ; but as re-development 
rapidly takes place, we must 
apply our remedy every six 
hours, and continue doing so 
for a fortnight after the ap- 
parent cure. A good for- 
mula being — 

B. Sulphuris precipitat., 

Zinci oxidi aa 5j ; or 4 Gm. 
Olei olivae §j ; 32 " 

Acidicarbolicigr. xvj. 1[06 " 
M. To bo rubbed4n for a few 
minutes. (R. Lee.) 

It is also readily absorbed We must therefore remem- 
through the skin. ber that symptoms of poison- 

ing may readily be produced 
by the application of carbolic 
acid over any considerable 
cutaneous area. 

Antiseptic System of Prof. Lister. 

Its principal application, The acid itself, being ex- 
however, in surgery, is in tremely irritating, is pre- 
enabling us to carry out the vented from coming in con- 
far-famed antiseptic system tact with the wound or sore 
of Prof. Lister. by a protection of oiled silk, 

This eminent surgeon, over which are superposed 

adopting the views of Pas- several layers of gauze im- 

teur, and believing that sup- pregnated with paraffin 16 

puration, pyaemia, and vari- parts, resin 4 parts, and car- 

ous other inconveniences con- bolic acid 1 part ; and this 

nected with open wounds, dressing need not necessarily 

arise from the irritation of be changed oftener than 

minute germs contained in every two or three days. 



CARBOLIC ACID. 



87 



the air, has devised a process 
in which the atmospheric air, 
before reaching the raw sur- 
face, is filtered through car- 
bolic acid and thus deprived 
of its irritating properties. 



Mr. Lister prevents the 
access of air during opera- 
tions by surrounding the part 
with an antiseptic atmo- 
sphere, composed of a sprayed 
watery solution of carbolic 
acid of 1 to 40, and the in- 
struments and fingers of the 
surgeon are carefully washed 
with carbolized oil, whilst 
the arteries are tied with car- 
bolized catgut ligatures, cut 
off short. By adopting these 
precautions, and attending 
most rigorously to the care- 
ful dressing of wounds, he 
has obtained excellent re- 
sults, not only after ordinary 
operations, but in chronic 
abscesses wherever situated, 
compound fractures, and va- 
rious diseased conditions con- 
nected with joints, whose 
cavities he is enabled to 
open and explore with per- 
fect safety. 



Internal Action. 



Carbolic acid, if adminis- 
tered in sufficient quantity, 
is very poisonous in its ope- 
ration, causing failure of the 
heart's action, spinal convul- 
sions, gastro-intestinal irrita- 
tion, and lowered tempera- 
ture. Its antiseptic properties 
sufficiently explain its inter- 
nal use. 



Carbolic acid has occa- 
sionally caused death by 
being accidentally drunk in 
mistake for beer, or by being 
incautiously applied to the 
skin. The best antidotes are 
olive oil and saccharated lime. 

It is occasionally given 
internally to counteract j#a£w- 
lence and sarcinous vomiting ; 
but the sulpho-carbolates, and 
more especially that of soda, 
are the most convenient forms 
for its administration in doses 



88 CHROMIC ACID — CITRIC ACID. 

of 15 to 30 grains. It has 
been used successfully as an 
inhalation in bronchitis and 
whooping-cough. [Carbolic 
acid has been recommended 
for tenia, in pill form, taking 
three to five grains in the 
course of the day.] 

Absorption and Mode of Elimination. 

Carbolic acid is rapidly absorbed, and quickly and entirely 
given off by the urine, to which it imparts a peculiar green- 
ish-black hue and its own peculiar smell. 



[ACIDUM CHROMICUM— CHROMIC ACID. 
Potassii Bichromas. (See Potassium.) 

Effects and Uses. 

Chromic acid is an escharotic and antiseptic ; it rapidly 
oxidizes organic matter and is the most energetic disinfectant 
known. A strong solution (gr. c. to f*j) may be applied 
with a glass rod, to destroy warts, condylomata, and excres- 
cences, or to reduce enlarged tonsils. Greatly diluted (gr. ss 
to f^j) it forms a detergent wash for mercurial stomatitis, 
scurvy, diphtheria, oedema of the glottis, ulcers, and phage- 
dena. On account of the difficulty of limiting its effect it 
should not be applied in substance, as when used in this 
manner to destroy warts on the fingers, it has been known to 
eat into the joint and require amputation of a phalanx.] 

[ACIDUM CITRICUM— CITRIC ACID. 
Officinal Preparations, U. S. 

Syrupus Aeidi Citriei (5j in Oj). Used as a vehicle. 

Liquor Ferri Citratis, Liquor Magnesiae Citratis, Liquor 
Potassii Citratis, Lithii Citras, Potassii Citras, and in pre- 
paring Ferri Pyrophosphas. 

Dose, gr. xx-xxx(=1.30 to 2. gms.). 

Effects and Uses. 

As a refrigerant in fevers, citric acid solution is used in 
the form of lemonade, neutral mixture (liquor potassii citra- 



DILUTE HYDROCYANIC ACID. 89 

tis), or the citrates. It has been used in scurvy, liver disease, 
and rheumatism, and as an application to the throat in diph- 
theria (gr. viiss to foj)« Dr. H. Bence Jones believes that 
lemon juice and citric acid increase the acidity of the urine ; 
they consequently are contra-indicated in lithuria, and 
should not be given for a length of time, continuously, in 
the gouty diathesis.] 

External Use. 

Citric acid was proposed a few years ago as a soothing 
local application to cancerous sores. 

Internal Use. 

Citric acid is used chiefly as a cheap and convenient sub- 
stitute for lemon juice in effervescing draughts, which are 
very extensively prescribed on account of their cooling and 
refreshing properties in feverish conditions, and for the 
soothing influence of their carbonic acid when the stomach 
is irritable. 

Whenever lemon juice can be procured, it should be used 
in preference ; but at periods of the year when this fruit is 
out of season, citric acid will act well, and we here give a 
table from Squire, showing the proportions in which the acid 
and alkali should be prescribed to insure exact saturation. 

17grs. (1.12 *] f 25grs. (1.6 gin.) bicarbonate of potash, 

gm.) of citric j j 20 " (1.3 " ) carbonate of potash, 

acid, or half I will J 20 " (1.3 " ) bicarbonate of soda, 

a fluid ounce j neutralize j 35 " (2.3 " ) carbonate of soda, 

offreshlem- 15 " (1. " ) carbonate of ammonia, 

on juice J [ 13 " ( .78" ) carbonate of magnesia. 

Acidum tartaricum, being cheaper than citric acid, is 
often used to construct effervescing draughts. 



[ACIDUM GALLICUM. See GALLA.] 



ACIDUM HYDROCYANICUM DILUTUM-. 
DILUTE HYDROCYANIC ACID. 

[J. two per cent, solution in water of anhydrous Hydrocyanic acid, U. S. P, 

Officinal Preparations, U. S. 

Argenti Cyanidum. \ N uged intenmll 
Hydrargyn Cyanidum. ) J 

8* 



90 DILUTE HYDROCYANIC ACID. 

Potassii Cyanidum, gr. T ^ to -^ (.005 gm.). 
Ferri Ferroeyanidum, 3ss (2 gm.). 
Potassii Ferroeyanidum, gr. x-xv (1. gm.). 

Poisoning. 

Prussic acid and the cyanide of potassium, in sufficient 
doses, are almost immediately fatal, so that in most cases no 
symptoms, except sudden collapse and death, are present. 
For a more detailed account of the effects, see page 92. 

Antidotes. 

Chlorine or ammonia may be cautiously inhaled, ac- 
companied by cold affusions to the spine, and artificial 
respiration. As a chemical antidote, sulphate of iron (gr. 
x), and tincture of the chloride of iron (f'5j)> dissolved in a 
fluid ounce of water, may be given immediately, to be fol- 
lowed by twenty grains of carbonate of potassium, likewise 
in solution, forming with the poison insoluble Prussian 
blue. 

Tests. 

The peculiar bitter almond odor. A physiological test can 
be made by injecting some of the suspected fluid, hypoder- 
micaliy, into a rabbit, and observing its effects. When a 
little potassa is mixed with liquids containing this poison, 
and solution of the sulphate or sesquichloride of iron added, 
a grayish-green precipitate is thrown down — which deepens 
to a Prussian-blue tint on addition of a few drops of sulphuric 
acid. The nitrate of silver produces a white {cyanide of 
silver) precipitate ; which, after being washed and dried, and 
then held on a watch-glass over a flame, burns with a fresh 
rose-color, cyanogen being at the same time evolved. 

Sulphur 2 y est — Place two drops of a solution of hydrosul- 
phate of ammonia, containing an excess of sulphur, in the 
centre of a watch-glass, and invert it accurately over the 
vessel containing the poisoned liquid. Remove the glass in 
three or four minutes, and dry the moistened spot gently 
over a spirit-lamp. Let a drop of water fall on the white 
film, and then a drop of the perchloride of iron. If prussic 
acid be present, a blood-red solution (sulpho-cyanide of iron) 
is produced ; and this red color is discharged by the addition 
of one or two drops of a solution of corrosive sublimate. 



DILUTE HYDROCYANIC ACID. 



91 



When a mixture is to be examined, containing matters 
from the stomach, etc., if alkaline, it must first be neutralized 
by addition of sulphuric acid, then one-eighth part cautiously 
distilled therefrom into a receiver immersed in some frigorific 
mixture ; and the product may then be tested by nitrate of 
silver, etc., as above.] 

External Action. 



Therapeutical. 

It is therefore used exter- 
nally, largely diluted, to re- 
lieve neuralgic pain and allay 
itching, more especially in 
skin disease. We may thus 
hope to alleviate the torment- 
ing irritation often attending 
prurigo and eczema ; but we 
must be careful never to let 
the lotion come in contact 
with any abrasion on the sur- 
face, as prussic acid is very 
readily and rapidly absorbed. 



Internal Action. 

Hydrocyanic acid, being the most powerful and speedy 
poison with which we are acquainted, requires to be pre- 
scribed with very great caution. 



Physiological. 

Prussic acid, applied to the 
skin in a concentrated form, 
may cause at first slight irri- 
tation, but secondarily dimin- 
ishes its sensibility, acting in 
some degree as an anaesthetic, 
probably from a benumbing 
influence on the extremities 
of the sensory nerves. 



Physiological. 

1. On the Nervous System. 
— Prussic acid has some ef- 
fect on the brain, causing 
giddiness and slight stupor ; 
the respiratory centre in the 
medulla next becomes weak- 
ened, and the motor nerves 
are more or less paralyzed, 
causing excessive muscular 
feebleness. 



Therapeutical. 

1. It is used with great 
benefit in those forms of dys- 
pepsia attended with epigas- 
tric pain and vomiting fol- 
lowing food, and whether 
depending on gastric ulcer, 
or on mere irritation of the 
mucous membrane. It has 
also been given in luhooping- 
cough ; but in my experience 
its action is here very uncer- 
tain, and I have been unable 



92 



DILUTE HYDROCYANIC ACID. 



to satisfy myself that it is a 
remedy of much value. In 
some forms of chronic and 
spasmodic cough it does 
good, but it is essentially in 
dyspepsia that we obtain 
real advantage from its use. 



3. It has been successfully 
employed in nervous palpi- 
tation [or irritable heart]. 



2. The respiration be- 
comes slow and irregular, 
and finally ceases, death in 
cases of poisoning being 
generally due to suffocation. 
The sensory nerves are also 
enfeebled in their conducting 
power. 

3. Prussic acid has a pow- 
erful sedative action on the 
heart, the circulation becom- 
ing slow, feeble, and irregular 
under the influence of poison- 
ous doses ; and this arises 
both from an influence on the 
nerves and on the muscular 
structures of the heart itself. 

It also acts directly on the 
blood, combining with the 
haemoglobin of the red cor- 
puscles, and preventing them 
from properly fulfilling their 
duty of carrying oxygen to 
the tissues. 

4. Prussic acid has no 
special influence on the tem- 
perature or on secretion, save 
that the saliva is generally 
increased in quantity. 



Prussic acid is very rapidly eliminated from the system, 
probably by the breath, and half an hour may be sufficient 
for this purpose, so that in a case of poisoning we may have 
good hopes of recovery, if we can sustain the powers of life 
during this period. 



DILUTE HYDROCYANIC ACID. 



93 



Poisonous Effects In a 

large dose prussic acid kills 
immediately, the victim fre- 
quently uttering a loud cry, 
and expiring from cardiac 
syncope. If the quantity 
taken be smaller, symptoms 
of suffocation supervene from 
paralysis of the respiratory 
centre, and, if the process of 
poisoning be more gradual, 
from deficient supply of oxy- 
gen in the blood ; other symp- 
toms noted being convulsions, 
great muscular prostration, 
dilatation of pupils, and quick, 
feeble, irregular pulse. In 
fatal cases, post-mortem ex- 
amination shows nothing cha- 
racteristic. 

If the poison be taken in 
a concentrated form, death 
may ensue very rapidly, in 
probably less than a minute ; 
and Preyer, who has devoted 
special attention to the sub- 
ject, has observed a guinea- 
pig to be apparently dead one 
second after inhaling some 
gaseous acid, all efforts at 
breathing having finally 
ceased in fifteen seconds. 
He, therefore, considers this 
to be the most deadly mode 
of its administration ; but no 
matter through which chan- 
nel it enters the body, it 
speedily kills any animal, 
and, curiously enough, it is 
equally destructive to plants. 



Dose and Mode of Administration. 
One grain of anhydrous acid has caused death, and of 
this the preparation used in medicine contains 2 per cent., 



Treatment. — Considering 
the great rapidity of the ac- 
tion of hydrocyanic acid, it 
is comparatively seldom that 
we have any opportunity of 
employing antidotes ; but sup- 
posing we see a case suffi- 
ciently early to do so, we 
should have vigorous recourse 
to cold affusion and the in- 
halation of ammonia and 
chlorine water. Artificial 
respiration should be then 
steadily persisted in, and if 
we can thus counteract the 
tendency to death by suffoca- 
tion, and tide the patient 
over the first half-hour, we 
may look forward to success, 
never despairing as long as 
the faintest pulsation can be 
felt in the heart. Secondary 
auxiliary means exist in the 
internal administration of am- 
monia, of chlorine water, or 
of carbonate of potash, fol- 
lowed by the mixed sulphates 
of iron, which convert the 
poison into Prussian blue ; 
and recently the subcutane- 
ous injection of atropia has 
been proposed as the true 
physiological antidote. 



94 LACTIC ACID. 

the old Scheele's, which is now obsolete, having contained 4 
per cent. 

In consideration of the rapid way in which the acid is 
thrown out of the system, we must repeat the dose fre- 
quently, from every hour to every three hours ; and it is 
well not to order too large a quantity at one time, not be- 
cause the acid tends to float on the top, as was formerly sup- 
posed, but because there is always a chance of an overdose 
being given through ignorance or carelessness. We may 
safely prescribe from 2 to G minims, beginning always with 
nr, j, suspending it if the patient complains of any constric- 
tion about the throat. For external use f5'j may be dis- 
solved in 8 ounces of water or rose-water. 

Gm. 





R. Acidi hydrocyanici 
Glycerini 
Aqua? rosse 
Misce, fiat lotio. 


diluti 


f5ij; 

ad f §viij 


or 

> 


8 
32 

256 




S. To be applied with 


a soft 


sponge. 






In 


a case of troublesome 


itching. 








Be. Acidi hydrocyanici 
Misturae amygdalae 


diluti 


"ixij; 


or 


192 



75 Gm. 

Misce, fiat mistura. Capiat cochlearia magna duo tussi 
admodum ingravescente. 

For a case of irritable cough. 

R. Acidi hydrocyanici dil. TT]xxv; or 1 60 Gm. 

Bismuthi subnitratis 

Syrupi aurantii 

Infusi gentian se 
Misce. Capiat cochlearia magna duo ter in die ante cibum. 

In a case of irritative dyspepsia. 

Or, a few drops of prussic acid may be added to the ordi- 
nary effervescing draught with good effect. 



TTixxv ; 


or 


1 


3 ss ; 


a 


2 


f§j; 


it 


32 


f§™j- 


a 


256 



[ACIDUM LACTICUM— LACTIC ACID. 

Officinal Preparation, U. S. 

Ferri Laetas. Dose, gr. v (.30 gm.). 

A syrupy, nearly transparent liquid, with -slight odor and 
a very sour taste, obtained from sour milk. It has been 
found in the gastric juice, and may prove a useful addition 
to preparations of pepsin. It has been given in dyspepsia 
(dose f'5j?) i n sweetened water at meal-time. Locally it 



MURIATIC ACID. 95 

has been employed (diluted four-fifths) as an application to 
the false membrane in croup and diphtheria. 

According to Prout, rheumatism is connected with an ex- 
cess of lactic acid in the blood ; and this fact accounts for the 
benefit derived from the alkaline treatment.] 



ACIDUM MURIATICUM— MURIATIC ACID. 

[An aqueous solution of hydrochloric acid gas, of the specific gravity 

1.160, U. S. 

Officinal Preparations, U. S. 

Aeidum Muriatieum Dilutum (giv. to Oj). Dose, 
n^x-xx (.60 to 1.20 gm.). 

Also enters into the preparation of Aeidum Hydrocyani- 
cum Dilutum, Antimonii Oxidum, Calcii Phosphas Prascipi- 
tata, Carbo Animalis Purificatus, Quinise Sulphas, Strychnia, 
Sulphur Prsecipitaturn, and Aeidum Nitromuriaticum, Aqua 
Chlorini, Barii Chloridum, Ferri Chloridum, Liquor Arsenici 
Chloridi, Liquor Calcii Chloridi, Liquor Ferri Chloridi, 
Liquor Zinci Chloridi, Morphias Murias, and Resina Podo- 
phylli. 

Poisoning. 

Hydrochloric acid is a corrosive mineral poison. It causes 
a burning pain in the pharynx and epigastrium, strong styp- 
tic, acid taste in the mouth, much thirst, tense and frequent 
pulse, dry and hot skin, red glazed tongue, lips black. There 
is vomiting of blood and yellow matter, having the odor of 
the acid. Some of the vomit falling on a marble table 
causes foaming, from escape of carbonic acid gas. Cold 
sweats, delirium, and collapse terminate life. After death 
the parts in contact with the acid are stained and highly 
inflamed, and may- be eroded. The vapor of ammonia pro- 
duces a characteristic white cloud of ammonium chloride. 
Nitrate of silver throws down a white precipitate, which 
afterwards becomes black. Only the presence of a large 
excess of free acid can establish the proof of poisoning by it. 

Antidotes. 

The same as the other mineral acids : the alkalies and 
their carbonates, magnesia, soap, and bland drinks may 



96 MURIATIC ACID. 

be freely given. Muriatic acid stains the mouth and lips 
black, when taken undiluted.] 

External Use. 

Hydrochloric acid is a good form of application to diph- 
theria when it is used combined with equal parts of honey. 

Internal Use. 

Of all the acids used in medicine, this has undoubtedly 
the most beneficial action in dyspepsia, on account probably 
of its forming one of the normal constituents of the gastric 
juice. In cases where we suspect the formation of an exces- 
sive quantity of this fluid, we may, on the principles already 
enunciated, limit its secretion by prescribing the acid imme- 
diately before meals. When the epigastric pain comes on 
immediately after eating, the condition is no doubt due to 
an irritable or perhaps ulcerated condition of the stomach 
itself, and we may best hope for success by carefully regu- 
lated diet, and the use of bismuth, soda, or hydrocyanic acid. 
But when the pain does not set in with severity until from an 
hour to a couple of hours after food has been swallowed, the 
explanation probably is that an abnormal excess of gastric 
juice has been secreted, and a recurrence of this will best be 
checked by giving a little of the acid before meals. 

Hydrochloric acid has also been much recommended by Dr. 
Chambers and others in typhoid fever, and it will generally 
be found that 20-minim doses of the dilate acid are very 
grateful to the patient, as quenching the thirst and moisten- 
ing the tongue. Dr. George Johnson has recently taken ex- ( 
ception to this, on the ground that the acid irritates the ulce- 
rated surfaces of Peyer's patches ; but not only does mere 
empirical experience demonstrate the harmlessness as well as 
the convenience of this mode of treatment, but it is quite 
evident that the contact of at least three alkaline secretions 
must considerably modify the reaction of the acid before it 
reaches the seat of disease, and prevent it from retaining 
much irritating power, and I should therefore look upon these 
view r s of Dr. Johnson as having little practical value. 

Dose. 

In dyspepsia rr^xx ad xxx (1.30 to 2. gm.). In typhoid 
fever n^xx (1.30 gm.) every two hours. 



NITRIC ACID. 97 

30 Gm. 



R . Acidi muriatici dil. n|xx ; or 1 

Sp. chloroformi ir]xv; " 1 

Inf usi gentianse f §j . 32 
M. S. Ter in die. 

In dyspepsia. 



ACIDUM NITRICUM— NITRIC ACID. 

[Nitric acid of the specific gravity 1.420, U. S. 

Officinal Preparations, U. S. 

Acidum Nitricum Dilutum (f^iij to Oj). Dose, 
n^iv-xv (.25 to 1 gm.). 

Also enters into Acidum Nitro-muriaticum, Argenti Nitras, 
Bismuthi Subnitras, Liquor Ferri Nitratis, Liquor Hydrar- 
gyri Nitratis, Spiritus JEtheris Nitrosi, Unguentum Hydrar- 
gyri Nitratis, and in the preparation of Acidum Phosphori- 
cum Dilutum, Antimonii Oxidum, Bismuthi Subcarbonas, 
Cadmii Sulphas, Hydrargyri Oxidum Rubrum, Liquor Ferri 
Chloridi, Liquor Ferri Subsulphatis, Liquor Ferri Tersul- 
phatis, Liquor Zinci Chloridi, and Pyroxylon. 

Antidotes.* 

The same treatment as indicated for poisoning by Muri- 
atic Acid and the other mineral acids. Nitric acid stains 
the skin yellow.^ 

External Use. 

Nitric acid is undoubtedly the best form of local applica- 
tion in all forms of sloughing or phagedenic ulceration, 
whether of venereal origin or otherwise. In these rapidly 
destructive forms of disease, we shall do well to place our 
patient under the influence of an anaesthetic, and then apply 
the strong acid freely and thoroughly to all parts of the 
affected surface, and we shall thus often succeed in arresting 
a process which would otherwise go on to severe and even 
fatal disorganization. 

It is also used locally in the treatment of piles, more espe- 
cially those flat irritable forms of tumor which do not come 
readily within the reach of the clamp or ligature. 

In the proportion of 10 or 20 minims to an ounce, nitric 

* The symptoms of poisoning are those of the corrosive mineral 
acids. 

9 



98 OXALIC ACID. 

acid forms a good astringent lotion in cases of indolent or 
unhealthy sores ; and it has been recommended by Dr. 
Roberts, of Manchester, as an injection into the bladder 
for the solution of phosphatic calculi. 

Internal Use. 

Given internally, nitric acid has tonic properties, and, in 
combination with bark and opium, acts well in cases of foul 
or sloughing ulceration. Again, in constitutions broken 
down by syphilis or by chronic hepatic disease, we may very 
beneficially give our patient from 15 to 20 minims of the 
dilute acid three times a day, its action on the liver being by 
some supposed to have somewhat of a specific character. 

Gm. 



60 



R. Acidi nitrici diluti i*5ij ; or 8 
Tincturse opii Tr|_xl ; " 2 

Tincturse cinehonse f§ss; "« 16 
Decocti cinehonse ad f §viij ; " 256 " 

Misce. Capiat cochlearia magna duo ter in die. 

In a case of foul or sloughing ulcer. 



ACIDUM NITRO-MURIATICUM— NITRO- 
MURIATIC ACID (3 to 5). 

Dose, nr,v-x (.30 to .60 gm.), well diluted. 

Aeidum Nitro-muriaticum Dilutum (f^iv to 
Oj). Dose, ttlx-xv (.60 to 1 gm.).] 

This is supposed to have some special action on the liver, 
and is most extensively used in chronic functional affections 
of that organ. It has also been highly recommended, in the 
form of bath, in various hepatic disorders in the proportion 
of 6 fluid ounces to each gallon of water. Or internally — 

R. Acidi nitro-nmriatici diluti f^ij ; 8i Gm. 

Extract, taraxaci f §ss ; 16 " 

Spiritus chloroformi [Br.] f^iss ; 6 u 

Aquae ad f^viij ; 256 " 
M. S. Capiat cochlearia magna duo ter in die. 

In a case of sluggish liver. 



[ACIDUM OXALICUM— OXALIC ACID. 

Officinal Preparation, IT. S. 
Ferri Oxalas. Dose, gr. ij-iij (.12 to .20 gm.). 



glacial phosphoric acid. 99 

Poisoning. 

Oxalic acid is a corrosive vegetable poison. It produces 
burning pain, nausea, and sometimes severe retching. Death 
may quickly ensue in collapse or convulsions, or may result 
from the subsequently developed severe gastro-intestinal in- 
flammation. 

Diluted it causes symptoms of cardiac paralysis. 

When death is produced by oxalic acid, in some cases no 
trace of the drug remains, or there may be nothing to show 
for it beyond inflammation of the alimentary tract. 

The test for oxalic acid is solution of calcium chloride, 
which causes a white precipitate (calcium oxalate). 

Antidotes. 

Magnesia and lime form insoluble precipitates with oxalic 
acid, therefore compounds containing chalk or magnesia 
would constitute chemical antidotes. Tooth-powder, lime- 
water, oxide and carbonate of magnesia, or " the scrapings 
of the ceiling with a fire-shovel," may be given with pro- 
priety in cases of poisoning; which are not infrequent, since, 
owing to the resemblance between oxalic acid and Epsom 
salts, one may be accidentally substituted for the other. The 
common names salts of sugar, and (in its combination with 
potassa) salts of lemon, tend to mislead the public as to the 
poisonous character of the drug. 

Effects and Uses. 

Oxalic acid has been used, in small doses, internally, in 
scurvy and phthisis, but has nothing particular to com- 
mend it.] 



ACIDUM PHOSPHORICUM GLACIALE— 
GLACIAL PHOSPHORIC ACID. 

[Officinal Preparation, U. S. 

Aeidum Phosphorieum Dilutum. Dose, nKviij- 
5j (.50 to 4. gm.). 

This acid was formerly held to be of advantage in diabetes, 
but more recent investigation has shown that instead of di- 
minishing it actually tends to increase the amount of sugar 



100 SULPHURIC ACID. 

given off by the urine. It therefore cannot be held to have 
any special significance from a therapeutic point of view, but 
may be adopted as an agreeable mode of introducing acid 
into the system, as its flavor is agreeable. We may take 
occasion, however, to mention a mistake which is not uncom- 
monly made in prescribing, and that is to prescribe phos- 
phoric acid with the view of obtaining the medical influence 
of phosphorus. Now it is well known that only from phos- 
phorus in a free condition do we obtain any real benefit, and 
of this phosphoric acid contains no trace. 

It has, however, been used as a tonic and alterative in 
rickets and scrofula: and is an excellent adjuvant to cough- 
mixtures, or tonics, for elderly patients.] 



ACIDUM SULPHURICUM—SULPHURIC ACID. 

[Syn. Elixir of Vitriol. 

Sulphuric acid of the specific gravity 1.843, U. S. 
Officinal Preparations, U. S. 

Acidum Sulphurieum Aromaticum. Dose, 
rr^viii-xxx (.50 to 2. gm.). 

Acidum Sulphurieum Dilutum. (fgij to Oj.) 
Dose, the same. 

Also enters into the manufacture of Acidum Sulphurosum, 
Aluminii Sulphas, Atropine Sulphas, Cadmii Sulphas, Ferri 
Sulphas, Hydrargyri Sulphas Flava, Liquor Ferri Subsul- 
phatis, Liquor Ferri Tersulphatis, Oleum ^Ethereum, Quinias 
Sulphas, Acidum Hydrocyanicum Dilutum, ^Ether, Argenti 
Cyanidum, Chloroformum Purificatum, Hydrargyri Chlori- 
dum Corrosivum, Hydrargyri Chloridum Mite, Hydrargyri 
Cyanidum, Pyroxylon, Sodii Phosphas, Spiritus iEtheris 
Nitrosi, and Veratria. 

Tests. 

If in a concentrated state, any organic matter placed in 
contact with it is blackened and charred ; when mixed with 
an equal bulk of water, much heat is evolved ; when boiled with 
copper filings or mercury, sulphurous acid gas is generated. 
When the acid is in a diluted state, the best test is nitrate 
of barium, which causes a dense white precipitate of sulphate 
of barium ; this can be verified by calcining it for some minutes 
with an equal weight of charcoal, wrapped in platina foil, 
then introducing the residue into a glass tube and adding a 



SULPHURIC ACID. 101 

few drops of muriatic acid. This will liberate sulphuretted 
hydrogen, which can be recognized by its odor, and by its 
blackening carbonate or acetate of lead. 

Poisoning. 

The symptoms are those of an acrid, corrosive poison. 
They come on suddenly after taking food or medicine, and 
the patient soon becomes collapsed. Recovery is apt to be 
followed by stricture of the oesophagus. 

Antidotes. 

Alkalies should be given in milk or soapsuds, though much 
water would be improper. Care should be taken not to rup- 
ture the stomach by the tube of the stomach-pump, or by 
inducing severe efforts at vomiting. The acid, when concen- 
trated, discolors the mouth and lips, making a black slough. 
When administered medicinally it should be taken much di- 
luted through a glass tube, in order to protect the teeth.] 

External Use. 

Strong sulphuric acid is the most powerful caustic of this 
group, rapidly charring and desiccating the tissues, from its 
great affinity for water. M. Yelpeau, of Paris, strongly re- 
commended its use in cancer, the acid bein°; made into a 
paste with saffron, and applied to the morbid growth, it 
being found, after detachment of the sloughs, that a clean 
ulcerating surface remained ; and Professor Syme proposed 
a modification of this plan, on the score of economy, by using 
sawdust instead of saffron. Ricord, of Paris, also advises the 
application of sulphuric acid in combination with charcoal to 
primary syphilitic sores, holding that, if this process is 
effectually carried out before the fourth day, we may hope to 
avert the evil consequences of constitutional infection. 

Mr. Pollock has advised the local use of strong sulphuric 
acid in caries and necrosis and suppurating synovial mem- 
brane of joints, either applied on a glass rod, or injected, or 
brought into contact on lint with the diseased surfaces, in the 
proportion of one part of acid to two, three, or six parts of 
water; and this plan of treatment has been used with good 
success in St. George's Hospital {vide " Lancet," May 28, 
1870, and "Medical Times and Gazette," December 11, 
1875.) 

9* 



102 



SULPHUROUS ACID. 



Internal Use. 

Diluted sulphuric acicl is a good astringent, and as such 
is extensively used in night sweats and in diarrhoea, more 
especially that which is so common in summer. It has also 
been advised, in the form of lemonade, as a prophylactic 
against painters' colic, and there is no doubt that it heightens 
materially the action of purgative salts, probably by increas- 
ing their solubility. 



$ 



Magnesii sulpliatis 

Ferri sulphatis 

Acidi sulpliurici diluti 

Iiifusi calumbae 
Misce, fiat mistura. 
S. Capiat cochlearia magna duo omni mane. 



F>. 



3'J ; 

■ gr. xxiv 

f3ij; 

ad f^viij; 



64 
1 

8 
256 



Gm. 

60 



Acidi sulpliurici diluti f 3iiss ; 10 Gm. 

Tincturse opii f £j ; 4 

Syrupi aurantii f §j ; 32 

Aqu?e ad f§viij ; 256 

M. S. Capiat unciam unam ter in die post singulas 
sedes liquidas. 



ACIDUM SULPHUROSUM— SULPHUROUS ACID. 

[An aqueous solution of sulphurous acid gas, having the odor of Jbnrning 
sulphur, and a sulphurous, sour, and somewhat astringent taste. Its 
specific gravity is about 1.035. 

Dose, f'5ss and f 3j (2. to 4. gm.). Largely diluted with 
water.] 

External Use. 

The therapeutic properties of this acid depend in part on 
its very poisonous influence on the lowest forms of animal 
and vegetable life. Thus it forms a good application to 
those varieties of skin disease, as tinea tonsurans, chloasma, 
etc., which depend on the presence of a minute cryptOgamic 
plant ; and Dr. Dewar some years ago published a pamphlet 
in which he ascribed to this acid powers little short of mar- 
velous. Going on this theory that a very great number of 
diseased conditions depend on the irritation of germs, Dr. 
Dewar most confidently advised its use in affections ranging 
from rheumatic fever to chilblains. Although experience has 
naturallv not borne out his extravagant assertions, we have 
to thank him for making known to us the undoubtedly good 



TANNIC ACID — TARTARIC ACID. 103 

effect of sulphurous acid in various forms of sore throat, used 
in considerable dilution either as spray or gargle. It is also 
a good disinfectant, as we know that the antiseptic properties 
of sulphur, when burnt for purifying purposes, depend on its 
formation. 

Internal Use. 

Sulphurous acid has been recommended by Dr. Lawson in 
pyrosis, the dyspeptic symptoms attending which are due to 
various forms of leptothrix and vegetable growths burrowing 
in the mucous membrane of the stomach ; and in flatulence 
it is also deserving of a trial. 



[TANNIC ACID. 

Officinal Preparations, U. S. 

Acidum Tannicum. Dose, gr. j-iv (.06 to .24 gm.). 
Unguentum Aeidi Tanniei (3ss to gj). 
Glyceritum Aeidi Tanniei (3y to fgj). 
Suppositoria Aeidi Tanniei, each gr. v. 
Trochisei Aeidi Tanniei, each gr. j.]. 

The test for tannic acid is albumen, gelatin, or the salts of 
iron ; with the first two it produces an insoluble precipitate, 
with the last a black* color in solution. 

Tannin is incompatible with albumen, gelatine, the gluco- 
sides, and substances containing alkaloids, and with most 
metallic salts in common use. 

For medical uses, see Galla.] 



[ACIDUM TARTAPvlCUM— TARTARIC ACID. 

Officinal Preparations, U. S. 

Ferri et Ammonii Tartras. Dose, gr. x-xxx 

(.60 to 2. gm.). 

Pulveres EfFerveseentes. (Soda powders.) 
Pulveres EfFerveseentes Aperientes. (Seidlitz 

powders.) 

Poisoning. 

Tartaric acid is a corrosive vegetable poison ; its symp- 
toms are very analogous to those caused by oxalic acid, and 
the morbid appearances likewise resemble those produced by 
oxalic acid. 



104 VALERIANIC ACID. 



Tests. 

When heated on platina foil, it burns with a pale reddish 
flame, and exhales a peculiar acrid vapor, leaving much car- 
bonized matter. When a solution is treated with lime-water, 
it affords a white precipitate, soluble in an excess of the acid; 
when treated with caustic potassa, it affords a granular pre- 
cipitate of the bitartrate. 

Antidotes. 

The alkalies, magnesia, lime, soap, or the alkaline car- 
bonates. 

Internal Use. 

It has been stated that tartaric acid, in .60 to 1.20 gm. (gr. 
x-xx) doses, given thrice daily will render the urine acid. 
The tartrate of magnesium has been recommended as a 
cheaper substitute for the citrate, as an aperient, and is con- 
sidered quite as efficient. In sweetened solution, tartaric acid 
is sometimes used as a refrigerant drink in fevers. The tar- 
trates are laxative and diuretic] 



[ACIDUM VALERIANIGUM— VALERIANIC ACID. 

A colorless liquid, of an oihj consistence, a penetrating disagreeable 
odor, and caustic taste. Its specific gravity is 0.935. U. S. 

Officinal Preparations, U. S. 

Ammonii Valerianas. Dose, gr. ij-v (.12 to .30 
gm.). 

Quiniffi Valerianas. Dose, gr. j-iij (.06 to. 18 gm.). 
Zinei Valerianas. Dose, gr. j-ij (.06 to .12 gm.). 

Properties. 

Valerianic acid is an example of an organic acid made by 
synthesis, through the oxidation of amylic alcohol (fusel oil) 
by chromic acid. The valerianate of the oxide of amyl is 
used as an artificial fruit-essence, when largely diluted. 

Valerianic acid is said to resemble valerian in its effects, 
and, in the form of the valerianates, may be used in nervous 
headache, neuralgia, and hysteria. The salts are best given 
dissolved in simple elixir, or in a pill.] 



ACONITE. 



105 



[Aeida. 

List of acids, officinal in the U. S. Pharmacopoeia : — 



Acidum Aceticuni 

" " Dilutum 

" Arseniosum 

" Beiizoicum 

1 ' Carbolicum 

" " Impurum 

' ' Chromicum 

" Citricum 

" Grallicum 

" Hydrocyanicuro. Dilutum 

" Laeticum 

" Muriaticum 

" " Dilutum 

" Nitricum 



Acidum Nitricum Dilutum 

' ' Nitro-Muriaticum 
" " Dilutum 

11 Oxalicum 

" Phosphoricum Dilutum 
" " Glacial e 

' ' Sulphuricum 
" " Aromaticum 

tl " Dilutum 

" Sulpliurosum 

" Tanuicum 

" Tartaricum 

" Valeriaiiicum.] 



ACONITUM— ACONITE. 

[Aeoniti Folia The leaves of Aconitum Napellus, 

U. S. 

Aeoniti Radix The root of Aconitum Napellus, U. S. 

Officinal Preparations, U. S. 

Aeonitia (from the root). Not given internally. 

Extraetum Aeoniti (of the leaves). Dose, gr. ss 
(.03 gm.). 

Emplastrum Aeoniti (from the root). 

Liniment um Aeoniti (from the root, §iv to Oj). 

Tinetura Aeoniti Radieis. (3yj to Oj.) Dose, 
gtt. j-v (.06 to .30 gm.). 

(Fleming's tincture of aconite root contains §xss to Oj.) 

Antidotes. 

Finely powdered animal charcoal, tannin, astringent in- 
fusions, and hot alcoholic stimulants, are useful. The stom- 
ach should be carefully washed out, and subsequent symp- 
toms met pro re nata.'j 

Poisonous Properties. Therapeutical. 

Aconite may kill either by In poisoning by aconite, 
direct cardiac syncope, or, we must endeavor to sustain 
if the action be less rapid, by the flagging action of the 



106 



ACONITE. 



respiratory failure. Great 
muscular weakness is noted, 
the heart's action becoming 
feeble and irregular, the face 
pale, the body bedewed with 
clammy sweat, the pupils first 
contracted, and then dilated 
shortly before death closes 
the scene. The resemblance 
of aconite root to horse-radish 
has afforded several lamenta- 
ble opportunities of studying 
cases of accidental poisoning. 



Local 

Physiological. 

Aconite, locally applied, 
causes a sensation of tingling, 
followed by numbness of the 
skin, from a paralyzing influ- 
ence, no doubt, on the sen- 
sory nerves. It may also 
brino- about some local vaso- 
motor paralysis. 



heart by giving stimulants, 
and keeping the patient most 
rigidly in the recumbent pos- 
ture, as death has occurred 
from syncope produced by 
suddenly sitting up in bed. 
Digitalis has been proposed 
as the physiological antidote, 
bracing up and restoring the 
contractility of the heart 
muscle (Fothergill). [20 
minims of tincture of digitalis 
may be administered hypo- 
dermically.] 

Action. 

Therapeutical. 

Aconite is a most valuable 
local sedative in painful ner- 
vous affections, and more es- 
pecially in facial neuralgia, 
where the tincture or lini- 
ment, applied along the course 
of the affected nerve, will 
often allay and even remove 
suffering. 



Constitutional Action. 



Physiological. 

1. On Nervous System. — 
1. Brain. — In poisoning by 
aconite, the intellectual facul- 
ties are usually quite unaffect- 
ed, but in some cases stupor 
has been observed. 

2. Spinal Cord Aconite 

paralyzes both the reflex and 
the motor activity of the cord, 
as evidenced by almost total 
loss of power in the muscular 
system. 



Therapeutical. 



ACONITE. 



10T 



The respiratory centre also 
eventually becomes paral- 
yzed, and death may result 
by suffocation. 

3. Although this loss of 
voluntary movement is sup- 
posed to be primarily spinal 
in origin, it is believed that 
the motor nerves themselves 
are secondarily affected, the 
paralyzing influence begin- 
ning at their peripheral ex- 
tremities. The inhibitory 
cardiac ganglia are first sti- 
mulated, and secondly de- 
pressed, and a sedative effect 
is produced on the sensory 
nerves, the earliest indication 
of the action of the drug 
being tingling followed by 
numbness and anaesthesia of 
the lips and throat. 

Opinions differ as to the 
influence of aconite on the 
vaso-motor nerves, and it is 
not believed by many autho- 
rities to have any special ope- 
ration over this system. Dr. 
Bagshawe, however, has pub- 
lished some cases of facial 
sympathetic paralysis, with 
injection and sweating, fol- 
lowing the local application 
of aconite, and the diaphoretic 
action, so often noted, must 
proceed from this cause. 
Experimental evidence, how- 
ever, is very conflicting in 
this, as well as in other 
points, respecting the physio- 
logical actions of aconite. 

II. Circulating Appara- 
tus — Aconite is essentially a 



3. Aconite is one of our 
best remedies in facial neu- 
ralgia, given either alone or 
in combination with quinine. 
In sick headache also it is of 
service, and here it will be 
prescribed along with tinc- 
ture of Indian hemp. 



II. Aconite is an excellent 
antiphlogistic, cutting short 



108 



ACONITE. 



cardiac sedative, slowing the 
action of the heart at first 
from inhibitory stimulation, 
but then causing an increase 
in the rapidity of the pulsa- 
tions, with feebleness and 
irregularity, ending in death 
by arrest of all movement in 
diastole. At the same time 
the arterial pressure falls in 
very marked degree. - 



inflammatory processes in 
their early stages. Thus in 
pneumonia, pleurisy, peri- 
tonitis, erysipelas, rheumatic 
fever, and in the short sharp 
feverish affections of children, 
it is of signal service, and 
seems to have a directly cura- 
tive action. Dr. John Har- 
ley (St. Thos. Hosp. Reports, 
New Series, vol. v.) made 
some interesting observations 
at the London Fever Hospital 
on the action of aconitia. 
He found that by giving ^o 
of a grain once a day, which 
was quite sufficient to produce 
physiological effects, no in- 
fluence was exerted on the 
course of 29 cases of scarlet 
fever, and that diaphoresis 
was only twice produced ; 
whilst in 20 cases of typhus 
but slight controlling influ- 
ence was exerted over the 
febrile process, although the 
cases did unusually well. 
This may prove either that 
the dose was not repeated 
sufficiently often, or that 
aconite has no real power 
over fully developed inflam- 
matory processes. In coryza 
and in acute tonsillitis, also, 
it has been much praised for 
the way in which it checks 
the full development of these 
troublesome affections, and it 
has been highly praised as 
given in 2 minim doses, 
where we have any reason to 
fear the occurrence of rigor, 
after catheterism. 



ACONITE. 



109 



III. Respiration and Tem- 
perature. — The respiratory 
movements tend to become 
slow, finally irregular, and 
in some cases, and almost 
universally in the lower ani- 
mals, death results from ces- 
sation of breathing. 

The temperature falls de- 
cidedly. 

IV. Digestive and Secret- 
ing Apparatus. — Aconite 
has no special influence on 
digestion. It increases some- 
what the salivary secretion, 
and augments largely the 
action of the perspiratory 
apparatus of the skin, bring- 
ing out in some instances an 
irritable vesicular eruption. 
The urine is also somewhat 
increased in quantity. 



III. Some part of the good 
effect of aconite in these fe- 
brile affections must be due 
to its power in slowing the 
breathing and reducing the 
temperature. 



IV. [It has been given in 
the vomiting of pregnancy, 
but with only temporary 
benefit.] 



Aconite is therefore an ex- 
cellent diaphoretic, and to 
this action in some degree is 
due its antipyretic properties. 



Absorption and Mode op Elimination. 

Aconite is rapidly absorbed, and given out probably by 
the urine. The alkaloid aconitia, if accidentally blown into 
the eyes or respiratory passages, causes well-marked con- 
junctival and bronchial irritation. Prof. Gubler, of Paris, 
values it very highly in neuralgia of the 5th nerve, which he 
has never known to resist a quarter of a milligramme of the 
nitrate of aconitia, corresponding to one-half milligramme of 
the pure drug. He thinks we distrust the drug too much, 
but draws attention to a peculiar precordial disturbance, 
with palpitation and cardiac irregularity, rarely following its 
use, and warns us never to employ it in heart disease. 

Cautions and Modes of Administration. 

The very poisonous nature of aconite renders caution 
necessary in its use, and we must prescribe it with great 
care in old persons, or where any suspicion exists of feeble- 
ness of the heart's action. In sound constitutions, however, 
10 



110 LARD — ETHER. 

and more especially in the case of children, we may use it 
with freedom, often obtaining really extraordinary results. 

It is essential to encounter the inflammation at an early 
stage, before structural changes have set in ; and it is im- 
portant to combine a little stimulant with the drug. In very 
acute cases, our best practice will be to give the tincture in 
small and very often repeated doses, carefully watching the 
effect on the pulse. One drop every ten minutes, half-hour, 
or hour, will be the best arrangement during the first day, 
after which every two hours will be a sufficient interval, the 
thermometer giving us meanwhile reliable information re- 
garding the progress of the inflammatory condition. In facial 
neuralgia, also, we shall obtain the best results by drop doses 
repeated at very short intervals, and in no case is it well to 
overstep a maximum dose of 5 minims. 

The alkaloid aconitia is occasionally used as an external 
application [in ointment, containing gr. j-ij to the ounce]. 



[ADEPS— LARD. 

The prepared fat of Sits Scrofa, U. S. 

Officinal Preparations. 

Unguentum, used as a vehicle. 
Ceratum, used as a vehicle. 

Lard is emollient and is sometimes used in frictions, but 
is chiefly employed in Pharmacy in the preparation of oint- 
ments and cerates. In obstetrical and gynaecological prac- 
tice, lard is considered to be a universal lubricant, and is 
rarely absent from the lying-in chamber, where it is also used 
as a detergent to remove the vernix caseosa from the new- 
born. Washed lard is occasionally employed to prevent the 
eyelids from adhering in catarrhal conjunctivitis.] 



^THER_ETHER. 

[Used in preparing Acidum Tannicum, Ceratum Sabinre, 
Oleoresina Capsici, Oleoresina Cubebee, Oleoresina Filicis, 
Oleoresina Lupulinae, Oleoresina Piperis, and Tinctura Opii 
Deodorata. 



ETHER. 



Ill 



Officinal Preparations, U. S. 

.ZEither Fortior — pure ether (for producing anaesthesia). 
Spiritus -ffitheris Compositus (Hoffmann's Ano- 
dyne). nr.x-5j (-60 to 4 Gm.). 

.ZEfcher fortior is used in preparing Aconitia, Atropine 
Sulphas, Collodium, Collodium cum Cantharide, Oleum 
.ZEthereum, and Oleoresina Zingiberis.] 



Local Action. 



Physiological. 

The projection on the skin 
of a very fine spray of spe- 
cially pure ether, by means 
of Dr. Richardson's ingenious 
instrument, causes at first a 
sensation of extreme cold, 
attended occasionally by the 
formation of frost. In about 
a minute, or even less, to this 
succeeds a sudden blanching 
of the surface, the skin be- 
coming hard and quite in- 
sensible, and a sharp cutting 
pain, like a burn, being at the 
same time experienced. 

If this action is kept up for 
some time, redness, tingling, 
vesication, and even slough- 
ing may be produced. 

Be careful always to pro- 
cure the pure anaesthetic 
ether, which has a low boil- 
ing point, and evaporates 
rapidly, as ordinary qualities 
of the drug are of no use for 
local anaesthesia. 



Therapeutical. 



Advantage has been taken 
of the insensibility to pain 
produced by the ether spray, 
to use it extensively during 
the performance of many 
minor operations, and more 
especially in those which 
consist merely of a single 
cut or prick. Under these 
conditions it acts admirably, 
but the hard and brawny 
state of the integument pro- 
duced by its action renders 
it of little or no aid where 
dissection or manipulations 
of deep-seated structures are 
required. Further objec- 
tions to its use are the acute 
pain attending application, 
and the subsequent redness, 
tingling, and irritation of the 
skin. 

It has also been recom- 
mended as a sedative in 
neuralgia, and as a con- 
venient means of applying 
intense cold ; and cases of 
its successful employment in 
chorea, applied to the upper 
part of the spine, have been 
recorded. 



112 



ETHER. 



Internal Actions. 



Ether, when taken inter- 
nally, is. stimulant and anti- 
spasmodic. The intoxicating 
effects rapidly produced, as 
rapidly pass away, and great 
excitement and exhilaration 
may be succeeded in an hour 
by perfect recovery. It has 
therefore been termed a dif- 
fusible stimulant. 



It is therefore a useful 
remedy in hysteria, flatu- 
lence, spasmodic asthma 
bronchitis, dilated heart, etc. 



Combined Internal and External Use. 



Physiological. 

Ether has powerful anaes- 
thetic properties, and differs 
from chloroform in the fol- 
lowing respects. It increases 
instead of diminishing the 
arterial pressure, and acts as 
a tonic to the heart, which 
continues to pulsate in fatal 
cases after the arrest of 
breathing. The following is 
the order of involvement of 
the nerve centres : — 

1. The cerebrum. 

2. The sensory centres of 
the cord. 

3. The motor centres of 
the cord. 

4. The sensory centres of 
the medulla oblongata. 

5. The motor centres of 
the medulla. 



Therapeutical. 

The stimulant action of 
ether on the heart has caused 
its use to be warmly advo- 
cated as in all respects supe- 
rior to chloroform. It can- 
not, however, be considered 
absolutely safe, and it labors 
under several disadvantages, 
such as the greater length of 
time required to produce 
anaesthesia, the violent strug- 
gling occasionally observed, 
the disagreeable smell of the 
drug, etc. ; whilst it occa- 
sionally even happens that 
some persons cannot be fully 
brought under its influence. 
Pneumonia and bronchial 
irritation have been observed 
by some French authorities 
to follow its inhalation, nor 
is its safety so great as has 
sometimes been supposed, as 
13 deaths from its use have 
been recorded in England, 
and probably 5 in America 
(Canthey Dawson, of Leeds. 
Brit. Med. Journal, March, 



ETHER 113 

1878). It is therefore doubt- 
ful whether it will ever effect- 
ually displace the more com- 
monly-used anaesthetic [']. 

Mode of Administration. 

It is most important that no air be admitted during ether 
administration, as most violent resistance and dangerous 
struggling supervene if the vapor be not inhaled in a state 
of purity. Non-attendance to this point caused ether to 
fall into discredit soon after its original introduction, and it 
is only lately that we have been fully convinced that, by 
using this simple precaution, we may readily obtain com- 
plete anaesthesia and perfect muscular relaxation in from 
three to eight minutes. Various inhalers have been devised 
to fit tightly over the mouth and nose, and it is here essential 
that some instrument of the kind should be used. 

When operating by artificial light, do not forget the in- 
flammable nature of the vapor of ether. [The length of time 
needed to get a patient under ether is no longer a difficulty. 
Within the last four or five years the use of ether has in- 
creased rapidly in England in consequence of the adoption of 
better methods of administering it. Formerly the ether was 
given so abundantly as to excite choking and violent strug- 
gling. Now, methods, which produce a certain degree of 
asphyxia, by preventing the access of fresh air and allowing 
the same air to be breathed over and over again, are gene- 
rally adopted. By causing this degree of asphyxia the pa- 
tient is made to take deep and frequent respirations, which 
carry the etherized atmosphere down to the lung cells. The 
atmosphere is thus made effective without being so strong as 

1 [These strictures must be considered as" the criticism of an 
English author upon English ether, which is declared to be of veiy 
inferior quality by those who have had an opportunity of person- 
ally comparing it with the American. This explains the adherence 
of the English to chloroform, in spite of its acknowledged greater 
danger ; and at the same time prevents them from understanding 
the popularity of ether in the United States. The fact is that the 
washed ether (sether fortior, U. S. P.) as made by Dr. Squibb, 
Powers & Weightman, and others, is perfectly free from the objec- 
tions just stated ; it is pure, nearly odorless, and efficient in almost 
the same doses as chloroform, while it is incomparably safer than 
its rival.] 

10* 



114 ALCOHOL. 

to cause local irritation. The least unpleasant way of inhal- 
ing ether is to begin with laughing-gas only, and introduce 
ether vapor gradually along with the gas, without allowing 
any fresh air to be admitted — C] 

[For Mr. Clover's observations upon the Choice of Anaes- 
thetics see page 48.] 

[^Etherea. 

jEther. Chloroform um puriiicatum. 

.iEther fortior. Oleum sethereum.] 



ALCOHOL—ALCOHOL. 

[Spirit of the specific gravity, 0.835, U. S. 
Officinal Preparations, U. S. 

Alcohol Dilutum. Diluted one-half with water. 

Alcohol Fortius. Spirit of the specific gravity 0.817. 

Vinum Xerieum. Sherry wine (about 19 per cent, 
alcohol). 

Vinum Portense. Port wine (about 23 per cent, 
alcohol). 

Spiritus Vini Galliei. Brandy (about 50 per cent, 
alcohol). 

Spiritus Frumenti. Whiskey (about 50 per cent, 
alcohol). 

Spiritus Myreia3. Bay rum (for external use). 

(Spiritus Genevan, gin, is not officinal; the Spiritus 
Juniperi Compositus of the Pharmacopoeia may be regarded 
as its equivalent.) 

Alcohol makes a good menstruum, and is the basis of the 
Spirits and Tinctures of the Pharmacopoeia ; the former 
being solutions of volatile substances in alcohol, the latter 
generally containing the active principles of plants obtained 
by maceration and percolation. 

Tests. 

The chemical test consists in removing the contents of the 
stomach, mixing them with distilled water, filtering, and dis- 
tilling in union with carbonate of potassium or sodium; the 
product is mixed with fused chloride of sodium, and again 
distilled. Alcohol, if present, will be found in the receiver.] 



ALCOHOL. 



115 



Antidotes. 

The treatment of acute alcoholic poisoning must consist in 
removing all the spirit from the stomach by means of the 
stomach-pump, and endeavoring to rouse the patient from 
his perilous state of coma by cold affusion, strong coffee, 
surface stimulation, and galvanism, whilst artificial respira- 
tion may be employed to stimulate the flagging breathing 
powers. In more chronic cases, withdraw all stimulant 
absolutely and at once ; insure sleep by chloral and bromide 
of potassium ; and try to diminish the morbid craving by 
capsicum, nux vomica, the mineral acids, and a liberal and 
varied diet. 



Local 

Physiological. 

Alcohol has some external 
astringent properties from its 
power of hardening albumen 
and thus condensing the tis- 
sues, whilst, from its rapid 
evaporation, it produces a 



cooling effect. 



Actions. 

Therapeutical. 

This hardening process has 
been turned to practical ac- 
count for the prevention of 
bedsores, and alcohol is also 
a usual ingredient in the now 
somewhat old-fashioned spirit 
or evaporating lotions. 



Internal Actions and Uses. 



1. On Brain and Nervous 

System Alcohol primarily 

stimulates the cerebral cen- 
tres by dilating their arte- 
ries, and so admitting more 
blood; secondly, excitement 
supervenes with impaired 
muscular co-ordination, and 
finally coma, which may 
prove fatal if the dose taken 
be sufficiently large. Whilst 
it may also in small doses 
stimulate the spinal cord, in 
larger quantities it undoubt- 
edly weakens the functions 
of that structure, causing in- 
disposition for active exer- 
tion, as well as actual want 
of power. This has been 



1. A moderate quantity of 
alcohol stimulates the mental 
faculties, whilst larger doses 
become narcotic and even 
anaesthetic. In chronic nerve 
debility, as neuralgia, we 
may often relieve pain by the 
use of stimulants ; but these 
are precisely the class of cases 
in which habits of intemper- 
ance are most readily formed. 

Nothing seems better 
proved than the fact that 
alcohol lessens the capacity 
for active muscular exertion, 
and it is therefore well to 
advise sportsmen, soldiers, 
and others who are about to 
undergo severe bodily fatigue, 



116 



ALCOHOL. 



proved by the experience of 
campaigns, but more espe- 
cially that in Ashantee, where 
it was found that alcohol dis- 
tinctly diminished the power 
of bearino; fatigue, and also 
bv the experiments of Parkes, 
which showed most conclu- 
sively that 2 or 3 ounce doses 
of spirit given several times 
per diem to a couple of 
healthy men engaged in la- 
borious work, caused a slight 
primary increase of energy, 
but a secondary well-marked 
indisposition for muscular ex- 
ertion, with actual diminution 
of bodily vigor. Dr. Wilks 
has also drawn attention to a 
remarkable series of cases in 
which paraplegia, with numb- 
ness, anaesthesia, and violent 
shooting pains, have been 
caused by the excessive and 
long-continued use of alcohol. 
On the sympathetic sys- 
tem the effects are somewhat 
varied ; for although the dila- 
tation of certain vascular 
areas must depend on para- 
lysis of these nerves, there 
seems no doubt that, as Binz 
has shown, alcohol in inflam- 
matory conditions stimulates 
the sympathetic, contracts 
the arterioles, and prevents 
that migration of the white 
corpuscles which constitutes 
the essence of this morbid 
process. The chronic abuse 
of alcohol causes nervous 
tremors and debility, gradu- 
ally leading up to that semi- 
maniacal state known as de- 



to reserve all stimulant until 
their day's work is over, 
when it may be of real ser- 
vice. In the Ashantee cam- 
paign a ration of rum on 
reaching camp at night 
seemed to revive the men 
after their exposure and la- 
bors. 

In those cases of chronic 
alcoholic poisoning described 
by Wilks, we must follow his 
advice, and entirely cut off 
all supplies of strong drink. 



This is, no doubt, one ex- 
planation of the beneficial 
action of alcohol in some 
cases of acute inflammation. 



ALCOHOL. 



117 



lirium tremens, in which the 
victim is haunted by the con- 
stant presence of spectral 
illusions, preventing sleep, 
and finally wearing him out 
if unchecked. The brain, 
like most of the internal or- 
gans of the body, suffers in 
alcoholism from the contrac- 
tion of new areolar tissue 
pressing upon and obliterating 
some of the nervous elements. 

2. On Heart and Circula- 
tion Alcohol in moderate 

doses has a stimulating in- 
fluence on the heart, and 
dilatation of the peripheral 
vessels and of those of the 
brain is produced. 

In chronic alcoholism we 
find a degenerated condition 
of the larger vessels, known 
as atheroma. 



2. To its action on the cir- 
culation, however, we must 
ascribe a good deal of the 
beneficial influence of alcohol 
in the treatment of disease. 
When the powers of life show 
signs of failing, when the first 
sound of the heart grows 
weak, the pulse feeble, com- 
pressible, and irregular, when 
syncope threatens, and deli- 
rium is beginning, the indi- 
cations for the administration 
of alcohol are complete, and 
it will be found to act well 
when the tongue moistens, 
the pulse gains in volume and 
regularity, sound refreshing 
sleep is obtained, and the 
temperature falls. It is, of 
course, difficult to lay down 
exact rules as to the precise 
stage of fevers at which we 
may best prescribe alcohol, 
but ordinarily we should do 
so in typhus about the seventh 
day, in typhoid the twelfth, 
in smallpox when the secon- 
dary fever is developed, and 
in acute inflammations, gen- 
erally, when the heart begins 
to fail, and the nervous sys- 



118 



ALCOHOL. 



3. Respiration and Tem- 
perature The old observa- 
tions of Liebig seemed to 
show that alcohol was a respi- 
ratory food, and was largely- 
burnt off in the lungs, thus 
aiding in the production of 
animal heat. It is now 
found, however, that under 
its use the carbonic acid given 
off from the lungs is dimin- 
ished, and that the body heat 
is lowered. The carbonic 
acid, however, is probably 
only apparently diminished, 
because it is retained in the 
blood. When but small 
doses are taken, only a slight 
cooling effect is produced, 
whilst large quantities may 
reduce the temperature by 
two or three degrees, the ex- 
planation being partly that 
the dilatation of the cutaneous 
vessels enables more blood to 
be removed from the heat- 
producing centres, spread out 
and cooled in the wide sheet 
of the superficial circulation, 
and then returned, to abstract 
more warmth from the inter- 
nal organs. Another curious 
fact is that alcohol also dimin- 
ishes the power of resistance 
to cold ; and this has been 
proved not only by the expe- 
rience of Arctic voyagers, but 
by the following experiment: 
If we place two animals, one 
of which has been dosed with 
alcohol, in a chamber of which 
the temperature has been re- 



tem to show indications of 
debility. 

3. This lowering of tem- 
perature must also be ex- 
plained by diminished tissue 
metamorphosis, and by a par- 
tial arrest of the oxygen- 
bearing function of the red 
corpuscles of the blood. It 
is therefore evident that we 
must warn persons about to 
be exposed to severe cold of 
the fallacious nature of the 
old notion that alcohol fur- 
nishes true warmth. Post- 
mortem temperature is also 
lowered by alcohol, thus prov- 
ing that part of this action is 
due to a chemical process, 
causing a paralyzing influence 
on the protoplasm of the heat- 
producing cells. To produce 
an antipyretic effect, an adult 
will require at least two 
ounces of absolute alcohol. 

There can, however, be no 
doubt that we may often alle- 
viate the evil effects of a chill 
by a dose of spirit [especially 
in the form of a hot toddy], 
which releases the capillaries 
of the skin from their state 
of morbid contraction, stimu- 
lates the circulation by whip- 
ping up the heart, and thus 
prevents congestion of inter- 
nal organs. 



ALCOHOL. 



119 



duced to 10° below freezing 
point, both will speedily be 
benumbed to sleep ; but whilst 
the healthy animal will be 
supported by the combustion 
of its tissues and survive the 
shock, its companion will 
perish from this heat-pro- 
ducing process being inter- 
fered with by the spirit. 

4. Intestinal Tract. — In 
small doses, alcohol stimu- 
lates the appetite and in- 
creases the supply of gastric 
juice ; but if given in larger 
quantities, this secretion is 
checked, nausea is produced, 
and the desire for food dis- 
appears. In the advanced 
stages of chronic alcoholism, 
the stomach is injured by the 
contraction of the new areolar 
tissue obliterating its glands, 
and hence we find dyspepsia 
with morning vomiting a 
very common symptom in 
drunkards. 

5. Secreting Organs. — 
Alcohol stimulates the liver, 
and this organ is one of the 
first to suffer from chronic 
abuse of stimulant, the areolar 
tissues being irritated, and 
an increased formation taking 
place, which gives a primary 
enlargement to the organ. 
These newly formed struc- 
tures, however, having the 
tendency to shrink or con- 
tract, gradually obliterate the 
true secreting elements of the 
gland, which grows smaller 
and harder, ascites eventually 
following from pressure on 



Alcohol is thus often bene- 
ficial in the case of weakly 
persons, and more especially 
at the extremes of life, by 
giving tone to the digestive 
organs and aiding the due 
assimilation of food. Al- 
though its use is by no means 
essential to the healthy, it is 
of great service to dwellers 
in large towns, and others 
whose mode of life involves 
much mental strain. [Spirits 
should never be taken into 
an empty stomach, but should 
be accompanied by food.] 

Binz values alcohol as a 
food in fevers, not as actually 
building up the tissues di- 
rectly, but as an easily burn- 
ing fuel, from whose combus- 
tion, in oft-repeated small 
doses, the heat required to 
generate vital force may be 
derived, sparing the reserve 
of fat in the body and pro- 
ducing force. 

Frankland puts down the 
force-producing power of al- 
cohol as 7 to coal 8. [But 
we must not overlook the fact 
that the power of the system 
to develop and utilize this fuel 
is very limited.] 



120 ALCOBOL. 

the portal vein and obstructed 
return of blood from the ab- 
dominal circulation. 

Kidneys Alcohol has no 

specially well-marked effect 
on the urinary secretion, but 
the kidneys may also suffer 
from the cirrhotic degenera- 
tion just described. 

Mode of Elimination. 

Alcohol very rapidly enters the blood, and is rapidly given 
out, in small part at least, by the breath, but it probably 
" undergoes combustion to a great degree in the body, main- 
tains or increases the body weight, and prolongs life on an 
insufficient diet. It is therefore entitled to be reckoned as a 
food" (Brunton). Much discussion has been expended on its 
elimination or combustion, and some years ago the hopes of 
temperance agitators were much raised by the apparent re- 
sult of experiments put forward by two French observers, 
which seemed to prove that all the ingested alcohol is given 
out unchanged in the urinary secretion. Anstie and Dupre, 
however, showed the fallacy of this by pointing out that even 
the urine of the most rigid abstainers contains a substance 
which cannot, by the chromic acid test, be distinguished 
from alcohol, and it has since been asserted that this may 
actually be alcohol derived from converted liver sugar. 

A good deal of uncertainty still prevails regarding the ulti- 
mate destination of alcohol. Some authorities believe that 
it is first converted in the blood into aldehyde, then acetic 
acid, and finally carbonic acid and water. Wanklyn holds 
that it may be converted in part, at least, into glycol ; but 
Binz tells us that no secondary product has ever been- found, 
and that it is directly oxidized into carbonic acid and water, 
being completely destroyed in the animal organism, more 
than three per cent, being never found in the urine, under 
the most favorable conditions. 

As regards the dose of alcohol it is manifestly impossible 
to lay down any hard-and-fast rules, as we must of necessity 
be guided by the constitution of the patient and the symp- 
toms of his special case. As a rule we may say that about 
8 oz. of brandy may be sufficient in typhus or any acute ill- 



ALCOHOL. 121 

ness, and that 16 oz. may be looked upon as the quantity 
which it is well not to exceed. In a state of health, 2 oz. 
of absolute alcohol per diem is usually considered a maxi- 
mum allowance. But we must always remember the golden 
maxim, never to permit stimulants to enter the stomach save 
in combination with food. 

It is of some importance to consider the forms of alcohol 
best adapted for varying cases, and we may say, generally, 
that champagne acts well in sudden and rapid sinking, whilst 
good whiskey or brandy may* be recommended in ordinary 
acute illness. Port and Madeira are well suited for cases of 
debility ; and in convalescence from acute illness and diges- 
tive feebleness, malt liquors and Burgundy will often be 
found to be of great service ; but we must always beware of 
the possibility of leading our patients into disastrous habits 
of self-indulgence by a lack of precision in our directions as 
to quantity. The actual amount to be taken at each dose, 
and the proper periods of administration, must be carefully 
written down, remembering that under these circumstances 
we must look upon the alcohol as a drug. In fact, some 
authorities go so far as to recommend that we should invari- 
ably use spirits of wine, to be prescribed in regular form ; 
but this is manifestly injudicious, as it is not only the crude 
spirit which is an active agent, but the sugar, ethers, and 
other ingredients, more especially of old wine, are of real 
value from a therapeutical point of view. 

We are bound, so far as may be, to insure all possible 
purity, and more especially to avoid the adulteration with 
fusel oil, as this admixture causes very heavy intoxication, 
with disagreeable headache and other after-eifects. Another 
injurious form of adulteration has been pointed out by 
Dr. Crichton Browne, and that is picrotoxine, which, added, 
as it often is, to beer, produces epileptiform seizures. 

The following are the relative proportions of absolute alco- 
hol in the liquors most commonly in use : — 

Brandy, gin, whiskey . . . . 30 to 50 per cent. 

Sweet Spanish and Italian wines . . 13 to 17 " 

Hock and claret 8 to 11 " 

Edinburgh ale ...... (J li 

Bavarian heer . . . . . 4 to 5 ' ' 

Stout ... .... 4 " 

[Spiritus -SCtheris Compositus is an alcoholic solu- 
tion of ether, impregnated with oil of wine, and is popularly 
11 



122 AMYLIC ALCOHOL — GARLIC. 

known as Hoffmann's anodyne liquor. It is used in hysteria 
and nervousness. Dose, ttl x to Jj (.60 to 4. Gra.)] 

Spiritus iEtheris Nitrosi. This preparation, in 
doses of from 2. to 8. grammes (from J fl. drachm to 2 fl. 
drachms), is diuretic and diaphoretic, and is much used in 
feverish conditions. 

[By the action of sulphuric and nitric acids upon stronger 
alcohol, nitrous ether is produced, which, in combination 
with alcohol, is called spirits of nitrous ether, or, commonly, 
sweet spirits of nitre.] 



[ALCOHOL AMYLICUM— AMYLIC ALCOHOL. 

Syn. Fusel Oil. 

A peculiar alcohol obtained from fermented grain or 
potatoes by continuing the process of distillation after the 
ordinary spirit has ceased to come over. U. S. 

Amylic alcohol is an active irritant poison, for which no 
direct antidote is known. 

Officinal Preparations. U. S. 
Ammonii Valerianas and Quini® Valerianas. 

In addition to valerianic acid and its salts, amylic alcohol 
is used in the manufacture of the non-officinal nitrite of amyl, 
which has become of sufficient interest to warrant extended 
notice. It has come into general use, although not yet ac- 
cepted by the Pharmacopoeia, and will be found among the 
new remedies at the end of this section. 

The valerianates are used for the same purpose (hysteria 
and nervousness) for which valerian formerly was given. 
For discussion of effects see Valerian.] 



[ALLIUM—GARLIC. 

The bulb of Allium sativum, U. S. 
Dose of the fresh bulbs, 3j-ij (4 to 8 Gm.). 

Officinal Preparation, U. S. 

Syrupus Allii. Dose, f 3j, or for an infant ni, v-x (.30 
to 4. Gm.). 

Garlic is a stimulating expectorant, and is used with good 
effect in the later stages of catarrhal bronchitis, or suffocative 



ALOES. 123 

catarrh in young children, in which cases it may also be used 
as a poultice to the chest. These poultices composed of the 
freshly boiled bulbs pounded into a mass, used either alone 
or with an equal quantity of linseed meal, may also be used 
in infantile convulsions, applied to the back and legs, or the 
oil of garlic may be used as a rubefacient. 

The following would be an appropriate formula for the 
catarrhal bronchitis of infants : — 

R. Syr. allii ffj : or 32 ; Gin. 

" ipecacuanhse f^iii ; " 12 " 

" tolutani f^v; " 20 " 

" acacia? f.^vj ; " 24 " 

Tinct. opii camphorat. q. s. ad f§iij ; " 256 " M. 
S. Dose, "nxxx to fgj.] 



ALOE— ALOES. 

[Aloe Barbadensis, Barbadoes Aloes. The inspis- 
sated juice of the leaves of Aloe vulgaris, U. S. 

Aloe Capensis, Cape Aloes. The inspissated juice ot 
the leaves of Aloe spicata, and of other species of Aloe. 

Aloe Soeotrina, Socotrine Aloes. The inspissated 
juice of the leaves of Aloe soeotrina. 

Officinal Preparations, U. S. 

Aloe Purifieata, purified aloes. Dose, gr. v-x (.30 
to .60 Gm.). 

Pilula^ Aloes. (Aloes and soap, aa 1 part.) 2 grs. 
aloes in each pill. 

Pilulae Aloes et Assafcetida^. (Aloes, assafcEtida, 
and soap, aa 1 part.) 1^ grs. aloes in each pill. 

Pilulae Aloes et Mastieh.es. (Aloes 4 parts, mastic 
and rose leaves, aa 1 part.) 2 grs. in each pill. 

Pilulae Aloes et Myrrha?. (Purified Aloes 4 parts, 
myrrh and aromatic powder, aa 1 part.) 2 grs. in each pill. 

Pilulffi Rhei Composite. (Each Aloes gr. jss, rhu- 
barb gr. ij.) 

Pulvis Aloes et Canella^. (Aloes, 4 parts, canella 
1 part.) 

Tinetura Aloes. (gss to Oj.) Dose, f3j-iij (4. to 
12. Gm.). 

Tinetura Aloes et Myrrhae. (aa^jss in Oj.) Dose, 
fffi-ij (4. to 8. Gm.). 

Tinetura Benzoini Composita. Dose, n^x-xxx 
(.60 to 2. Gm.). 



124 



ALOES. 



Vinum Aloes (aloes, cardamom, and ginger, in sherry 
wine). Dose, f'3j (4 Gm.). 

Suppositoria Aloes. Each containing gr. ij of puri- 
fied aloes.] 

Physiological Action. 

Aloes acts on the lower 
part of the large intestine, 
stimulating its peristaltic 
movements, and causing the 
evacuation of formed and only 
slightly softened feces. Jt 
also increases the secretion of 
bile, and some authorities 
hold that its purgative action 
is merely secondary to this. 
A good deal of congestion 



about the rectum is produced, 
and a sympathetically stimu- 
lating effect may extend to 
the uterus, and tend to excite 
its functions. 

The recent experiments of 
Rutherford have shown aloes 
to be possessed of undoubted 
cholagogue properties. 

[The active principle is 
termed Aloin, which is some- 
times used instead of aloes in 
from one-half to one-third of 
the dose. " Its cathartic ac- 
tion is said to be uniform, 
rather more speedy than that 
of crude aloes, and unattended 
by griping." 1 ] 



Therapeutical Action. 

Aloes is a very certain, ef- 
ficient, and mild purgative 
[in doses of ten to twenty 
grains], acting, however, 
rather slowly, and seldom 
producing its effects before 
from six to twelve hours. 

It occasionally, however, 
gripes, and is, therefore, 
usually given in combination 
with other remedies which 
diminish this tendency, and, 
from its action on the lower 
bowel, it must be avoided in 
any local inflammatory con- 
dition, or in the acuter forms 
of haemorrhoids. 

Its mild and slow action 
has caused it to be much used 
in dyspepsia; it forms a prin- 
cipal constituent of most din- 
ner pills ; and it is also a 
popular remedy in habitual 
constipation. It has also em- 
menagogue properties de- 
pending partly, no doubt, on 
the sympathy of contiguity. 
In the form of pill or de- 
coction, and given, as laid 
down by Graves, at the time 
when the catamenia are natu- 
rally expected, it often proves 
most efficient. [The purified 
aloes should be used, as the 
commercial aloes contains im- 
purities.] 



1 The National Dispensatory, Phila., 1879, p. 137. 



marshmallow — alum. 125 

Dose, etc. 

The most useful preparations of aloes are, the compound 
decoction, dose, fgj to f^ij ; l the pil. aloes et myrrhoe ; and 
aloes and iron. 

[For chronic constipation : — 



M. 



For chronic constipation, in women with uterine dis- 
order : — 

12 Gin. 

06 " M. 



*• 


Ext. belladonnge 
" colocyntb. comp. 


g r - 1 ; 


or 


01 




Aloes, a,ii 


gr. jss ; 


t i 


09 




01. anisi 


™U; 


a 


06 




Ft. pilula. 








s. 


Dose, two or three at bedl 


ime. 







$. Aloe gr. ij ; or 

Ferri snlpliat. 

Terebinth, alb., aa gr. j; " 

Dose, one or two pills per diem. 



Suppositories of aloes are used against ascarides.] 



[ALTHJEA—MARSHMALLOW. 

The root of Alihcea officinalis, U. S. 

Marshmallow is a demulcent, as it contains chiefly muci- 
lage and starch. It is occasionally exhibited as a decoction 
in fevers, or inflammation of mucous membranes. In the 
form of a confection it is popular as a pectoral.] 



ALUMEN— ALUM. 

[Aluminii et Ammonii Sulphas, U. S. 

Dose, gr. x to xx (.60 to 1.30 Gm.), or, as a purgative, gr. v 
to 3j (.30 to .4 Gm.). 

Alumen Exsiccatum. Dried alum.] 

Local Action. 
Physiological. Therapeutical. 

Alum, used externally, It is, therefore, much em- 
tends, like most astringents, ployed as an astringent lotion 

1 [This is a favorite preparation of the British Pharmacopoeia. 
It contains aloes, licorice, carbonate of potassa. myrrh, saffron, and 
tincture of cardamom, and is gently cathartic] 

11* 



126 



ALUM. 



to contract the bloodvessels 
and condense the tissues by 
coagulation of their albumen. 



in conjunctivitis, leucorrhoea, 
gonorrhoea, and as a gargle 
in sore throat. [Dried alum 
is a mild escharotic for exu- 
berant granulations, etc.] 



Internal Actions and Uses. 



. 1. On Nervous System 

Alum seems to have some 
power in relieving spasmodic 
action. 



2. Circulation This, no 

doubt, is intimately connect- 
ed with No. 1, as the con- 
traction of the bloodvessels 
and internally astringent ef- 
fects which follow the use of 
alum are probably dependent 
on nervous influence. 

3. On Secretion Alum 

occasionally acts both as an 
emetic and as a purgative. 



1. It is, therefore, benefi- 
cial in some cases of whoop- 
ing-cough, and in colica pic- 
tonum. [In whooping-cough 
it is given in small doses of 
gr. j-ij (.06 to .12 Gm.), in 
syrup and water several times 
daily. It is also one of the 
best direct emetics in croup. 
Dose, 3ss (2. Gm.), repeated 
every half hour if necessary.] 

2. Alum has been used for 
internal hemorrhage, and to 
check excessive sweating, and 
its action in whooping-cough 
is also largely due to its astrin- 
gent properties, as it is most 
useful in the later stages, 
when profuse secretion • has 
been established. 

3. This also explains . its 
use in colica pictonum. 



or 



1 60 Gm. 

128 " M. 



Use. 
In lotion, gr. ij ad x : — 

R. Aluminis gr. x 

A qua? rosse f'§iv ; 

Lotion in catarrhal ophthalmia. 

R. Aluminis £ij ; or 8 Grm. 

Acidi sulphurici dil. f^j ; " 4 " 

Syrupi limonis f§j ; " 32 " 

Aquge fgiij ; " 96 " M. 

S. Capiat cochleare magnum secunda quaque hora. 

In colica pictonum. 

[Dried alum may be given in pill, gr. ij (.12 Gm.), in 
hcemoptysis.~\ 



ALUMINII SULPHAS — AMMONIA. 127 

[ALUMINII ET POTASSII SULPHAS. 

Potassa-Alum, U. S.~\ 



[ALUMINII SULPHAS. 

Sulphate of Aluminium, U. S. 

The potassa-alum has the same medical properties as the 
officinal alum, just considered, and, in fact, was the Alumen 
of the Pharmacopoeia in the edition of 1860. 

The sulphate of aluminium is antiseptic and astringent. 
It is sometimes employed as an injection in gonorrhoea and 
leucorrhoea. It has also been used to fill carious teeth, and 
in solution is employed to inject and preserve subjects for 
dissection.] 



[AMMONIACUM— AMMONIAC. 

A gum-resinous exudation from Dorema Ammoniacum, U. S. 

Officinal Preparations, U. S. 

Mistura Ammoniaei. Dose, f^ss (16. Gm.). 
Pilulae Scillae Composite. Dose, pills j-ij. 
Emplastrum Ammoniaei. 
Emplastrum Ammoniaei cum Hydrargyro. 

Internal Effects. 

Ammoniac may be used in chronic bronchitis with defec- 
tive secretion, but its systemic influence is not very evident. 
It is given in substance (dose gr. x-xxx) or rubbed up with 
water so as to form the Mistura Ammoniaei, or milk of am- 
moniac. The pills (each containing squills gr. ss, ginger 
and ammoniac, aa gr. ij with soap) are expectorant and 
stimulating. The plasters are resolvent and mildly counter- 
irritant, being useful in enlarged joints and scrofulous tumors.] 



AMMONIA— AMMONIA. 

[Officinal Preparations, U. S. 

Aqua Ammonise Fortior. (About 26 per cent, of 
Ammonia.) 



128 AMMONIA. 

Aqua Ammonias. (About ten per cent, of Ammonia.) 

Linimentum Ammoniae. (Aq. Amnion. -J, oil f.) 

Liquor Ammonii Acetatis. Dose, f Jss-j (16. to 
32. Gm.). 

Spiritus Ammonise. Dose, ttl x-xv (.60 to 1. Gm.). 

Spiritus Ammonias Aromatieus. Dose, f3ss-j (2. 
to 4. Gm.). 

Tinetura Guaiaei Ammoniata. Dose, f5j (4. 
Gm.). 

Tinetura Valerianae Ammoniata. Dose, f5j-ij 
(4. to 8. Gm.). 

Alumen. Dose, gr. x-5y, as an emetic. 

Ammonii Benzoas. Dose, gr. x-xx (.60 to 1.30 Gm.). 

Ammonii Bromidum. Dose, gr. x-xv (.60 to 1. Gm.). 

Ammonii Carbonas. Dose, gr. x (.60 Gm.), as an 
emetic gr. xxx (2 Gm.). 

Ammonii Chloridum. Dose, gr. v-xx (.30 to 1.30 
Gm.). 

Ammonii Chloridum Purificatum. Dose, gr. v- 
xx (.30 to 1.30 Gm.). 

Ammonii Iodidum. Dose, gr. v-x (.30 to 1.30 Gm.). 

Ammonii Nitras (used in making Nitrous Oxide). 

Ammonii Sulphas (used in making Ammonio-ferric 
Alum). 

Ammonii Valerianas. Dose, gr. ij-v (.12 to .30 
Gm.). 

Cuprum Ammoniatum. Dose, gr. J-J (.01 to .03 
Gm.). 

Ferri et Ammonii Citras. Dose, gr. v-x (.30 to 
.60 Gm.). 

Ferri et Ammonii Sulphas. Dose, gr. iij-x (.18 to 
.60 Gm.). 

Ferri et Ammonii Tartras. Dose, gr. x-xxx (.60 
to 2. Gm.) 

Hydrargyrum Ammoniatum, used in ointment.] 

Poisoning. 

If given in large quantities, ammonia may cause death by 
inflammation of the stomach and intestines ; and, according 
to Richardson, it may also kill by dissolving the red cor- 
puscles of the blood. 



AMMONIA 



129 



[Antidotes. 

Vegetable acids and demulcents. The fixed oils may be 
administered, and the usual after-treatment instituted for 
poisoning by the caustic alkalies.] 



Local Action. 



Physiological. 

The stronger preparations 
of ammonia are irritating to 
the skin, causing redness and 
speedy vesication on account 
of their power of dissolving 
the cuticle. 



Chloride of ammonium, on 
the other hand, is rather 
soothing, and cools the skin 
by aiding the speedy evapo- 
ration of fluids. 

The vapor of ammonia is 
stimulant and irritating. 



Therapeutical. 

Ammonia is, therefore, a 
component part of many stim- 
ulating liniments, and is an 
excellent counter-irritant and 
vesicant. It is a good ap- 
plication to the sting of in- 
sects or the bite of poisonous 
snakes. 

Chloride of ammonium 
used to be an invariable in- 
gredient in evaporating lo- 
tions. 

Ammonia is used by inha- 
lation in syncope, and as an 
aid in the restoration of per- 
sons poisoned by prussic acid ; 
but care must be taken not 
to allow its vapor to enter 
the air-passages too freely 
during unconsciousness, or 
serious inflammation may be 
produced. 



Constitutional Actions and Uses. 



I. On Brain and Nervous 

System The preparations 

of ammonia, generally speak- 
ing, are stimulant in their 
action, affecting, however, 
rather the ganglionic and 
spinal systems than the brain 



I. Ammonia in its various 
preparations is very largely 
used as a stimulant in many 
cases of exhaustion and de- 
bility. It is the best means 
of combating the depressing 
influence of snake-bite ; it is 



130 



AMMONIA. 



proper, and thus differing 
from alcohol. 



Chloride of ammonium 
has, according to Anstie, the 
property of giving increased 
tone to sensory nerves 



II. Circulation and Respi- 
ration. — Ammonia increases 
the force and frequency of 
the heart's action, this ex- 
plaining some part of its 
stimulating influence. It 
may also aid the respiratory 
power by giving tone to the 
muscular fibres surrounding 
the bronchial tubes, and 
stimulating the respiratory 
centre. 

When injected into the 
blood, ammonia has the 
power of dissolving the red 
blood corpuscles [perhaps, to 
a moderate extent. But the 
chief source of danger after 
intra-venous injection lies in 
its power of interfering with 
the function of the blood-cell 
as an oxygen carrier. In 



invaluable in bronchitis, pneu- 
monia, and all typhoid condi- 
tions, being more diffusible 
and less stupefying than alco- 
hol ; whilst in prassic-acid 
poisoning it may be admin- 
istered internally as well as 
externally. 

Chloride of ammonium is 
very serviceable in many 
cases of neuralgia, and in 
those wearing muscular pains 
in hard-worked women and 
others usually described un- 
der the term myalgia. [Am- 
monium bromide has been 
highly recommended in acute 
rheumatism in doses of gr. 
xx-xxx, three or four times 
daily.] 

II. It is therefore a very 
generally used stimulant in 
acute disease. 



It has therefore been used 
with success by Richardson 
in those cases where, as after 
delivery, diphtheria, ovari- 
otomy, etc., a clot is forming 
in the heart, and he recom- 
mends it by injection into 
the veins, stopping short of 
solution of the red corpuscles. 



AMMONIA. 



131 



cases of fatal ammonia poison- 
ing the blood, after death, is 
found to be dark and to con- 
tain very little oxygen, nor 
will it absorb the gas and 
become arterialized when agi- 
tated in an atmosphere of 
pure oxygen. The red blood- 
corpuscle is also found to be 
altered and to show unusual 
resistance to the action of 
acetic acid.] And it is also 
supposed to diminish the 
coagulating property of the 
blood and to assist in the 
solution of fibrinous concre- 
tions already formed. 

III. On Secretion. — Un- 
der this head it may be con- 
venient to place — 

1. The emetic action which 
is specially developed by 
large doses of carbonate of 
ammonia. This effect is also 
produced by injection into 
the blood. 

2. Ammonia increases the 
secretion from the bronchial 
mucous membrane. 



3. Intestinal. — Ammonia 
in large doses increases the 
secretion from the intestines, 
and may cause diarrhoea, and 
it also neutralizes acid secre- 
tions. 

4. Cutaneous Ammonia, 

more especially in the form 



1. Carbonate of ammonia 
is used as an emetic to assist 
in clearing the air-passages 
from accumulated mucus, and 
in some cases of poisoning. 

2. This, in addition to the 
stimulant action, explains 
the great power of ammonia 
over bronchitis in the weak, 
young, or aged, and the later 
stages of pneumonia., where 
it promotes expectoration by 
thinning and rendering the 
sputa less tenacious. 

3. It is never used as a 
purgative, but this irritating 
action on the bowels may 
render it an undesirable form 
of stimulant in enteric fever. 
It is a useful antacid. 

4. Liquor ammonii ace- 
tatis is one of our best dia- 



132 AMMONIA. 

of liquor ammonii acetatis, phoretics in a great variety 
acts freely on the skin. of feverish conditions. 

5. Urinary — No special 
action. 

Finally, ammonia has been employed under various condi- 
tions which cannot conveniently be grouped under any precise 
physiological heading; but these we will consider when we 
refer seriatim to the various preparations of the drug. 

Mode of Elimination. 

Ammonia is very rapidly given out from the system, 
principally by the urine, but also in lesser degree by the 
breath and sweat. 

Preparations. 

Ammonia? liquor fortior [Br.] and liquor ammonia? [Br.]. 
These are seldom used internally, but occasionally as men- 
tioned above, by vapor and injection. Dr. Halford, of Aus- 
tralia, has also proposed the employment of ammonia in this 
way to neutralize the poison of snake-bites ; but, unfortu- 
nately, wider experience has not confirmed the promise of his 
earlier researches. Dose by injection, from 10 to 20 minims. 

Ammonii carbonas. This is the most active and efficient 
preparation, used as a stimulant in doses of from 3 to 10 
grs., as emetic 30 grs. Some authors have looked upon 
ammonine carbonas as a specific for scarlet fever, but of the 
soundness of this view no sufficient evidence has been pro- 
duced. It is nauseous and pungent, and must be well dis- 
guised, milk being a good vehicle. 1 

50 Om. 



U. Ammonite carbonatis 


gr. xl ; or 2 


Tincturse scillse 


f.qjii ; " 8 


Syrupi tolutani 


f5iij; - 12 


Decocti senegge 


f|vij; " 224 


Misce, fiat mistura. 




S. Capiat unciam unam quai 


ta quaque hora. 



Stimulating expectorant. 

Spiritus ammonia? aromaticus contains nutmeg, lemon, and 
spirit in addition to the ammonia. [This is an agreeable pre- 
paration either for inhalation or internal administration.] 

1 [Carbonate of auimonia inust not be prescribed in combination 
with syrup of squill or syrup of garlic, as they contain acetic acid.] 



J?ij ; 


or 


8Gm 


§?s ; 


« i 


16' " 


t'5.j ; 


a 


32 " 


ad f § viij ; 


it 


256i " 



ALMOND. 133 

Ammonii chloridum. Used as a tonic in neuralgia, in 
doses of from 20 to 30 grs. ; but it is very nauseous, resem- 
bling sea-water in flavor. [It is also a common addition to 
expectorant cough mixtures.] 

I£. Ammonii chloridi 

Ext. glycyrrhizae 

Syrupi tolutani 

Aq. cinnamomi ad f § viij ; " 256[ " M. 

S. ^j quartis horis. 

In neuralgia, or bronchitis. 

It has also, but with little real foundation, been supposed 
to possess some power of aiding the absorption of lymphatic 
and glandular enlargements, and has been regarded as a good 
remedy in chronic liver disease. 

Ammonii bromidum seems to have an occasional and un- 
certain influence over whooping-cough, and is thought by 
some to be a good substitute for bromide of potassium in 
epilepsy and other nervous disorders. 

Liquor ammonii acetatis and liquor ammonii citratis [Br.] 
are diaphoretic in doses of from f'Jij to f^j (8 to 16 Gm.). 

I£. Liq. am. acetatis f §ij ; or 64[Grm. 

Syrupi limonis f^j; " 32 '• 

Sp. seth. nit. f 5iij ; " 12 " 

Infusi serpentariae ad f 3viij ; " 256J " M. 

S. Dose f ^j quartis horis. 

Diaphoretic mixture- 
Ammonite benzoas, ammoniae nitras, and ammoniae phos- 
phas [Br.] are seldom if ever used. 



AMYGDALUS— ALMOND. 

[Amygdala Amara. The kernel of the fruit of Amyg- 
dalus Communis, variety amara, U. S. 

Amygdala Duleis. The kernel of the fruit of Amyg- 
dalus Communis, variety duleis, U. S. 

Officinal Preparations, U. S. 

Mistura Amygdalae (used as a vehicle). 
Oleum Amygdalae Amarae. Dose, gtt. \ (.01 Gm.), 
in emulsion. 

Oleum Amygdala? Expressum (duleis). 
Aqua Amygdala? Amara?. Dose,f^ss (16. Gm.). 
12 



134 STARCH — ANGUSTURA BARK. 

Syrupus Amygdalae (Orgeat syrup). Dose, f'3j to 
§ss (4 to 16 Gm.). 

Unguentum Aquas Rosas (from oil of sweet almonds). 

Antidotes. 

The antidotes to poisoning by the preparations of bitter 
almonds are the same as those of hydrocyanic acid.] 

The bitter almond, being uncertain and dangerous, is never 
used in medicine ; but sweet almonds, in the form of the 
mixture or powder, are of value as agreeable vehicles for the 
mixture or suspension of other drugs, and Dr. Pavy has 
taken advantage of their nutritive properties to propose them 
as a substitute for bread in saccharine diabetes. 

[The effects of the oil of bitter almonds upon the system 
are identical with those of hydrocyanic acid, upon the pres- 
ence of which its activity depends, but it is about four times 
the strength of the officinal Acidum Hydrocyanicum Dilu- 
tum. Bitter almond water, and the syrup, are used as vehi- 
cles for cough mixtures.] 



AMYLUM—ST ARC H. 

[ The feculum of the seed of the Trkicum vulgare, U. S. 

Starch is used medicinally as an antidote to iodine, and as 
a demulcent in corrosive poisoning. In the form of a dusting 
powder it is applied to the skin of infants to prevent chafing 
and excoriation.] 

Starch is a demulcent, used with advantage to some irri- 
table conditions of skin in the form of the glycerine of starch, 
and also as a medium for enemata. 



ANGUSTURA— ANGUSTURA BARK. 

[The bark of Galipea officinalis, U. S.~] 

Cusparia is a light tonic, rarely used. [It has fallen into 
disrepute, from the fact that it was occasionally found to be 
adulterated with nux vomica bark.] 



ANISE — ANTIMONT. 135 

ANISUM— ANISE. 

[The fruit of Pimpinella Anisam, U. S. 

Officinal Preparations, U. S. 

Aqua Anisi. As a vehicle. 

Oleum Anisi. Dose, gtt. v-xv (.30 to 1. Gm.). 

Spiritus Anisi. (Oil f Jj in Oj.) 

Anise is carminative and stomachic, and is a favorite 
flavoring ingredient in medicines for children.] 

Anise, Fennel, Coriander, Caraway, and Dill are agree- 
able aromatics, stomachics, and carminatives. 



ANTHEMIS— CHAMOMILE. 

[ The flowers of Anthemis Nobilis, U. S. 
Officinal Preparations, U. S. 

Infusum Anthemidis. Dose, f gij (64 Gm.) as a 
tonic ; as an emetic ad lib. 

Oleum Anthemidis. Not officinal. Dose, gtt. v-xv 
(.30 to 1 Gm.). 

An agreeable aromatic ; in small doses it is drunk as a 
tonic, and in large doses the hot infusion is taken as an 
emetic. A poultice is sometimes made of the boiled flowers.] 

Chamomile has usually been considered a substance of no 
special therapeutic interest, being principally used by country 
people in the form of infusion as a remedy for dyspepsia ; 
but within more recent years various German authorities, 
quoted by Phillips, have stated that the oil has a powerful 
lowering action on the reflex irritability of the spinal cord, 
and have proposed its use in cases of strychnia poisoning. 



ANTIMONIUM— ANTIMONY. 

[Officinal Preparations, U. S. 

Antimonii Sulphuretum — the purified tersulphide 
(used in making the oxide). 

Antimonii Oxidum. Dose, gr. ij-iij (.12 to .20 Gm.). 

Antimonii et Potassii Tartras. Dose, gr. T ^ to j 
(.005 to .06 Gm.). 



136 ANTIMONY. 

Antimonium Sulphuratum (sulphurated antimony). 
Dose, gr. j-xx (.06 to 1.30 Gm.). 

Antimonii Oxysulphuretum (Kermes mineral). 
Dose, gr. ss-j (.03 to .06 Gm.). 

Pilulae Antimonii Composite. (6 grs. of the mass 
contains 1 gr. each of calomel and sulphurated antimony.) 
Plummer's Pills. 

Vinum Antimonii — (Tartar emetic, gr. ij ad fgj). 
Dose, gtt. x (.60 Gm.) ; as an emetic, t5j (4 Gm.). 

Emplastrum Antimonii (Tartrate of Antimony and 
Potassium, 1 part in 4). 

Unguentum Antimonii (Tartrate of Antimony and 
Potassium, 1 part to 4). 

Syrupus Scillse Compositus (contains Tartar 
Emetic gr. j in gj).] 

Metallic antimony is not regarded as a poison ; but its 
vapor is said to cause unpleasant symptoms when respired. 

Antimony, Tartarized, generally known as Tartar Emetic, 
is an irritant metallic poison. 

Symptoms of Poisoning. 

Nausea and severe vomiting, hiccough, cardialgia, burning 
heat at the epigastrium, severe colic and purging, small and 
rapid pulse, cold skin, syncope, difficult respiration, vertigo, 
insensibility to external stimulants, painful cramps in the 
lower extremities, and great prostration of strength. 

Morbid Appearances. 

The stomach and intestines often much inflated w r ith gas ; 
their mucous membrane red, and covered with a slightly ad- 
hering viscid layer; the peritoneum of a dark brick-red hue; 
the membranes of the brain displaying marks of inflamma- 
tion.] Death may occur from the collapse following pro- 
longed vomiting and purging, or may be the result of gastro- 
intestinal inflammation. Post-mortem examination of a 
protracted case generally discovers parenchymatous degene- 
ration of the liver and other internal organs. 

[Tests. 

In a solid state, add charcoal, introduce into a test-tube 
and expose to heat ; metallic antimony will be deposited, of 



ANTIMONY. 



137 



a grayish-black lustre. In solution, diluted nitric acid causes 
a white precipitate. Sulphuretted hydrogen throws down a 
reddish-orange precipitate. Tannin causes a copious, curdled, 
whitish-yellow precipitate. Should matters from the stomach 
be present, the solution must be well agitated with a small 
portion of muriatic and tartaric acid, and filtered previous to 
being experimented upon. 

Treatment. 

Encourage vomiting by free administration of warm w 7 ater 
and other diluents, or employ the stomach-pump, if neces- 
sary. Infusions, tinctures, or extracts, containing tannin, 
are very useful by decomposing the poison. Give tea, coffee, 
and stimulants.] ■ 

Local Action. 



Physiological. 

Externally applied, tartar 
emetic causes redness and in- 
flammation of the skin, fol- 
lowed by an eruption of pa- 
pules becoming vesicular, and 
finally forming pustules close- 

pox. 



resembling those of small- 



Therapeutical. 

Tartar emetic used to be 
extensively employed in the 
form of ointment as a coun- 
ter-irritant, but was found 
occasionally to cause inflam- 
mation, and to leave unsightly 
scars. 



Internal Action and Uses. 



I. Brain and Nervous Sys- 
tem Tartar emetic under 

certain conditions, and more 
especially when combined 
with opium, exerts a sedative 
influence on the brain. 

When given in poisonous 
doses, paralysis, probably of 
spinal origin, and attended 
with diminished reflex irrita- 
bility, sets in. 

II. Circulation and Respi- 
ration. — Antimony is seda- 
tive in its operation on the 
heart and vascular systems, 



I. Its use was originally 
recommended by Graves, and 
has been endorsed by Murchi- 
son, in the violent delirium 
of typhus, and it has also been 
employed with benefit in de- 
lirium tremens. 



II. The depressing influ- 
ence of tartar emetic on the 
circulation caused it to be 
very generally used in former 



12 : 



138 



ANTIMONY. 



the heart's action becoming 
slow, M r eak, and finally irreg- 
ular, the arterial tension low- 
ered, and the pulse soft and 
compressible. The respira- 
tion also grows slower, and 
an increased secretion takes 
place from the bronchial mu- 
cous membrane. 



General muscular relaxa- 
tion is observed. 



III. On Secreting Organs. 

1. Stomach and Intestines 

Antimony is an effectual 
emetic, its action being slow, 
however, and attended by a 
good deal of depression. It 
acts either when swallowed, 
or by subcutaneous injection ; 
but the balance of experiment 
goes to show that in either 
case the effect is produced by 
reflex action following irrita- 
tion of the nerves of the sto- 
mach. Some increase of se- 
cretion from the intestines 



years in acute inflammations, 
and more especially pneumo- 
nia. ; but this practice has 
now been almost generally 
abandoned, as it was found 
that such treatment, whilst 
exerting no real influence 
over the course of the disease, 
tended to reduce the strength 
of the patient, and cause lin- 
gering convalescence. Small 
doses, however, are found 
useful in croup [spasm of the 
larynx"], and in the broncho- 
pneumonia of children where 
great dyspnoea and fever exist 
with excessive bronchical se- 
cretion, and it is a good gene- 
ral expectorant in asthma, 
[the first stage of] bronchi- 
tis, etc. 

Its relaxing effects on the 
muscular system were former- 
ly taken advantage of for the 
reduction of hernice and dis- 
locations ; but it has of course 
been quite superseded by chlo- 
roform and other anaesthetics. 

1. Antimony is too slow 
and depressing an emetic to 
be used in cases of poisoning, 
but it is of service in croup, 
ivhooping -cough , bronchitis, 
etc., where we wish to relax 
the bronchi and get rid of ac- 
cumulated secretions. 

In former years, when an- 
timony was freely given, what 
was called tolerance used to 
be an interesting therapeutic 
result. This is to say, in 
feverish conditions, it was 



ANTIMONY. 



139 



and consequent diarrhcea are 
occasionally observed. 



2. In poisonous doses an- 
timony causes irritation and 
inflammation of the stomach 
and intestines. 

3. Skin Antimony has a 

powerful diaphoretic action. 



found that large quantities of 
the drug might be taken with- 
out producing vomiting ; and 
this has been explained by 
the observation that anti- 
mony, to act as an emetic, 
must previously be dissolved 
in the gastric juice, a secre- 
tion which is in great mea- 
sure checked during fever. 
Gubler explains the tolerance 
more simply, by suggesting 
that the system is too weak to 
carry out the energetic series 
of action causing vomiting. 



3. Antimonial wine is a 
common adjunct to diapho- 
retic mixtures. It has been 
used in small doses with good 
result in psoriasis from its 
chemical relationship with 
arsenic. 



Commonly used Preparations. 

Antimonium tartaratum (Br. P.). [Antimonii et Potassii 
Tartras.] Dose, T ^ gr. to J.gr. ; as emetic, 1 to 3 grs. In 
the bronchitis of children, from ^L gr. to y 1 ^ gr. 

Vinum Antimonii. Dose, 15 to 40 minims. 

Ung. Antimoni tartarati. [Unguentum Antimonii, U. 
S. P.] 

Pulvis Antimonialis. This is the patent preparation known 
as James's powder, which used to be more popular than it is 
now. 

None of the other preparations of antimony have any spe- 
cial therapeutic value. 



140 antimony. 

Mode of Elimination, etc. 

Tartar emetic rapidly enters the blood, and is eliminated 
by the bile, milk, sweat, and urine, as well as the gastro- 
intestinal glands. 

Form of Administration. 

Tartar emetic, on account of its tastelessness, may be well 
given dissolved in simple distilled water ; and Ringer tells 
us, and I have amply confirmed his statements, that we may 
do much good, in some forms of acute bronchitis in children, 
by dissolving a grain of the salt in a pint of water, and giv- 
ing a teaspoonful every quarter of an hour for the first hour, 
and then hourly. 

In the case of adults, when we wish to avoid the nauseat- 
ing effects of the drug, we may best do so by the following 
formula? : — 



g r - !j ; 


or 




tt^xxx ; 


a. 


2 


f §ss ; 


a 


16 


ad f §vj ; 


a 


192 



R. Antimonii et potassii tart. 

Acidi hydrocyanici diluti 

Spiritus lavandulae comp. 

Aquae destillatae 
Dose, f§ss quartis horis. 1 

I£. Liq. opii sed 2 f 5j ; or 

Antimon. et pot. tartratis gr. j ad gr. ij ; 
Aquae caniphorae f j§vj ; 192 



12 Gm. 
(< 

tt 
" M. 

Gm. 

06 " 
" M. 



S. Sumat seiniunciam onini liora donee somnus supervenerit. 

Highly recommended by Graves and Murchison in the 
insomnia and delirium o£ typhus fever. 

[Tartar emetic in broken doses is very useful in acute 
pneumonia, from its action on the skin as well as on the 
respiratory centre. The following formula has been used in 
Philadelphia for a number of years, having been introduced 
by the late Dr. Pepper, one of the physicians to the Penn- 
sylvania Hospital : — 

R. Antioaonii et potassii tart. 

Pulv. digitalis 

Pulv. ipecac, comp. 
Ft. chart, no. xx. 
S. Capiat unam secunda quaque hora, 

1 [Each dose contains two and one-half minims of dilute hydro- 
cyanic acid. This being the case, the first dose should not exceed 
f 3J ; to be cautiously increased.] 

2 [Battley's solution, non-officinal.] 



g r - 2 ; 


or 




03 Gm. 




gr. x; 


n 




60 " 




gr. xl ; 


a 


2 


60 " 


M. 



WATER. 



141 



AQUA—WATER. 

[Natural water in the purest attainable state, U. S. 

Aqua Destillata. Distilled water.] 

Water, both in its external and internal applications, en- 
ters so largely into medical practice as well as into domestic 
economy, that we cannot begin our studies better than by 
considering very briefly what is definitely known regarding 
its physiological and therapeutical properties. 

[Water being the universal solvent is not found pure in a 
natural condition, but is more or less impregnated with saline 
or organic matters, and always contains in solution more or 
less solid, liquid, or gaseous impurities. Pure water boils at 
100° (212° F.) at the level of the sea; if it contain much 
foreign matter its boiling point may be raised. Mineral 
waters are those which permanently contain an unusual 
quantity of saline substance in solution. Hard water con- 
tains carbonate, or sulphate of lime and magnesia; the former 
being remediable by boiling is called removable hardness, 
while the latter is permanently hard. Hard water will not 
make a lather with the ordinary alkaline soap, but simply 
curdles by the lime combining with the fat. This is the 
basis of division of water into hard and soft; spring and 
well water are often hard ; rain and river water are usually 
soft. 

The following classification of water is furnished by the 
Rivers' Pollution Commissioners in their sixth report, etc. : — 

I. In respect of wholesomeness, palatability, and general 
fitness for drinking and cooking — 



Very 
palatable. 
^ Moderately 
\ palatable. 



( 1. Spring water 
Wholesome •< 2. Deep well water 

(3. Upland surface water 

( 1. Stored rain water 
Suspicious ■< 2. Surface water from culti-^ 

( vated land 

( 1. River water, to which y Palatable 
Dangerous ■< sewage gains access 

( 2. Shallow well water 

II. According to softness — 

1. Rain water. 

2. Upland surface water. , 



142 WATER. 

3. Surface water from cultivated land. 

4. Polluted river water. 

5. Spring water. 

6. Deep well water. 

7. Shallow well water. 

III. In respect of the influence of geological formation in 
rendering water sparkling, colorless, palatable, and whole- 
some by percolation, the following water-bearing strata are 
given as most efficient — 

1. Chalk. 

2. Oolite. 

3. Green sand. 

4. Hastings sand. 

5. New red and conglomerate sandstone.] 1 

Baths and External Applications. 

It will be found difficult, if not impossible, to balance the 
physiological and therapeutical actions of water in the manner 
followed generally throughout this work, and we shall there- 
fore give a short collective sketch of the influence exerted by 
it on the various functions of the body. 

It is not necessary for us to do more than refer to the uni- 
versal use of water for washing and bathing purposes, but a 
word or two on the physiological effects of cold baths is re- 
quired. We find that the action of the heart is increased, 
the respiration may become panting and irregular, the tem- 
perature falls, and the destructive metamorphosis of muscular 
tissue is augmented, as indicated by an increased excretion 
of urea ; occasionally albumen appears in the urine, and so 
much mental shock is produced, more especially by sea- 
bathing, as to render this usually excellent tonic unadvisable 
in those of feeble or hysterical constitution, in the very young 
and old, and in pregnant or menstruating women, whilst the 
tendency to vascular strain must prescribe caution towards 
those in whom we have any reason to suspect aneurism or a 
degenerated state of the arterial system. 

Occasionally, during sea-bathing, the hair falls off, the 
process of digestion becomes impaired, and sleeplessness is 

1 [Given by Wilson, in his "Handbook of Hygiene," Am. ed., 
Philada. 1877, pp. 141-142.] 



WATER. 143 

experienced ; and this, no doubt, arises from the process of 
tissue destruction not being thoroughly balanced by repair. 

As regards the external uses of cold water in medical prac- 
tice, we may refer to the beneficial action of water-dressing 
and irrigation in surgery, to cold affusion in laryngismus 
stridulus, cholera, hysteria, the stupor of fevers and drunken- 
ness, and, most of all, to the wonderful refrigerant action of 
cold baths in cases of abnormally high temperatures. 

It is generally held that a fatal result almost inevitably 
occurs in any case where the bodily temperature remains 
above 107° for several clays at a time, and until very recently 
we were powerless to check the destructive influence of this 
complication. Within the last few years, however, Drs. 
Wilson, Fox, and others have shown that we may safely and 
effectually bring down this excessive heat in rheumatism, 
where it principally occurs, by placing the patient in a bath 
at 95° and gradually adding cold water or ice until 60° Fahr. 
is reached. In this way a reduction of from seven to twelve 
degrees may be readily effected, but we must remember one 
practical point, that the patient's temperature continues to 
fall, as much even as six degrees, for forty or fifty minutes 
after he has been removed to bed, in consequence of the pri- 
mary contraction of the vessels of the skin, due to the fever 
and the cold water, being succeeded by relaxation and con- 
sequent irradiation of heat (Binz). Four or five baths may 
be required during the first day of treatment, the patient 
remaining immersed during twenty or thirty minutes. There 
can be no doubt that by watching our cases of rheumatism 
carefully, and adopting this mode of treatment whenever the 
thermometer registers more than 105° Fahr., we may save 
many lives. We may remember that the lowering effect is 
in inverse proportion to the weight of the body, and that the 
best effects are produced at the time when the temperature 
has a tendency to sink spontaneously, as from seven in the 
evening till morning, and again from 11 to 2 in mid-day. 
We must beware of collapse, which is no imaginary danger, 
and must be met by stimulants. 

The Germans use the cold bath very freely in all febrile 
disorders. Liebermeister keeps his patients in the water for 
even two hours in severe cases ; but there is no evidence that 
their success is greater than under the treatment pursued in 
this country, which has the merit of being agreeable to the 
feelings of the sufferer. 



144 WATER. 

Cold packing is an excellent stimulant to the skin ; it is 
useful as a less effectual but more agreeable mode of usino- 

• • • ^ 

antipyretic treatment, and is of service in acute eruptive dis- 
orders, when the rash tends to recede ; and is extensively 
employed at our hydropathic establishments. 

Warm water is also very serviceable, and we may mention 
the soothing action of warm fomentation, the warm douche 
in early joint disease, and the use of the warm bath in the 
convulsive diseases of children, for the relief of colic, spas- 
modic stricture, hernia, gall or renal calculi, and in cases of 
extensive burns or moist skin diseases, employed after the 
manner of Hebra, whose patients frequently remain in a state 
of continuous soaking for days together. 

Ice is a most valuable application for relieving pain and 
checking inflammation in orchitis, bubo, meningitis, etc., as 
well as for the arrest of hemorrhage, and to allay thirst and 
obstinate vomiting ; and introduced into the rectum it pro- 
duces some antipyretic action. 

Vapor is often used as a soothing and relaxing application 
in tonsillitis, bronchitis, croup, etc., and, in the form of bath, 
to cause diaphoresis. 

Constitutional Action. 

When water is taken internally, it acts in some measure 
as a purgative by supplying moisture to the feces ; it pro- 
motes digestion by stimulating the secretion of gastric juice, 
and aiding the passage of peptones into the blood (Ringer) ; 
and it is in some measure a diuretic, increasing temporarily 
the excretion of chloride of sodium, and more permanently 
the elimination of urea, phosphoric and sulphuric acids by 
the urine. It is, of course, the universal solvent, and its 
importance in the animal economy is shown by the fact that 
it constitutes about sixty-eight of the hundred parts which 
build up our entire bodily frame, and that five pints are 
given out from the body of one average-sized adult in the 
twenty-four hours. The urgent necessity for its purity is 
further proved by the leading part it has always taken in the 
spread of epidemics ; for not only cholera, but enteric fever, 
has thus been largely propagated, whilst entozoa are thus 
introduced into the system, and the presence of other impu- 
rities may give rise to dysentery, diarrhoea, goitre, and 
yellow fever. [The most dangerous adulteration of drinking 



WATER. 145 

water is that occasioned by the presence of decaying organic 
or albuminoid matter. During epidemics of bowel affections, 
all water should be boiled previous to drinking.] Specific 
adulterations also, like lead, have frequently occasioned very 
painful and even fatal attacks of illness. 

But we may derive great benefit in practice from the use 
of some of those very impure waters, deeply impregnated 
with various mineral ingredients, which are known as mineral 
waters, and which are met with in such profusion and variety 
both at home and abroad. Fashion, no less than undoubted 
success attending their use, has recently brought these natu- 
rally adulterated waters prominently forward, and it is very 
essential that every practitioner should have some knowledge 
of their chief constituents and the principal health resorts 
where they can be partaken of in greatest perfection. Our 
present limits, however, will only permit a very bare enume- 
ration of the principal classes into which mineral waters have 
been divided. 

1st. We have the chalybeate or ferruginous class, which 
contains iron in varying proportion, in the form either of 
carbonate held in solution by carbonic acid gas, as at [Ex- 
celsior Rock Spring, Saratoga] Spa, Tunbridge Wells, and 
Harrowgate ; or of sulphate, as at [Bedford Springs, Pa., 
Fairmount Park, Phila.] Brighton, Isle of Wight, etc. Some 
are hot and some cold, and some, as Monte Dore, contain a 
minute quantity of arsenious acid. They are possessed of 
tonic properties, and are very useful in cases of anaemia, 
chlorosis, struma, and other conditions of debility; and whilst 
we generally find them best borne as carbonate, Ave must be 
cautious of their use in very plethoric and full-blooded 
patients. 

2d. Acidulous or carbonated. These are agreeable and 
sparkling, holding in solution carbonates of lime, soda, and 
magnesia. They are met with at [Gettysburg] Seltzer, and 
Carlsbad, and are serviceable in gout and dyspepsia. 

3d. Saline, some of which are purgative by containing the 
sulphates of magnesia and soda, as at [Saratoga, Empire 
Spring] Cheltenham, Leamington, Friedrichshall, etc. ; 
others, as Buxton, Bath, and Bristol, are impregnated with 
carbonate and sulphate of lime ; others with chlorides, as 
Weisbaden, Baden-Baden ; a fourth class contain iodine and 
bromine in combination with sodium and magnesium, as at 
Homburg, Kissingen, Woodhall, etc. ; whilst a fifth class, as 
13 



146 SILVER. 

at Vichy and Ems, owe their properties to the alkaline car- 
bonates which they contain. [Apollinaris and Hunyadi 
Janos waters belong to this class.] These waters are much 
used for their tonic and aperient action. 

4th. Sulphuretted or hepatic waters contain sulphuretted 
hydrogen in solution, and possess a very offensive taste and 
smell. They are generally thermal, frequently having a 
high temperature. They are chiefly met with at Harrow- 
gate, Moffat, Cheltenham, Aix-la-Chapelle [Virginia Sulphur 
Springs], Bareges, Eaux Bonnes, etc., and are principally 
used in chronic skin diseases, in chronic rheumatism and 
bronchitis, in advanced syphilis, and for the elimination of 
mercury. 

Those patients who are unable to visit the different spas 
at home or abroad, may drink the bottled waters, or we may 
manufacture rough imitations by combination of the various 
ingredients. In prescribing saline purgatives, we should 
always remember the principle of very free dilution and 
frequently repeated small dose on an empty stomach ; but, 
although we may often do great good by this mode of admin- 
istration, we miss the change of air and scene, the early and 
regular hours, the simple diet, and the special faith and 
mental anticipation with which the chronic rheumatic and 
dyspeptic approach the health resort of their choice. 



[Aquae. 

The class of Medicated Waters in the U. S. Pharma- 
copoeia includes the following : — 

Aqua Acidi Carbolici Aqua Chlorinii 

" " Carbonici " Cinnamomi 

" Ammoniae " Creasoti 

" Ammoniae Fortior " Destillata 

" Amygdalae Amarae " Foeniculi 

" Anisi " Menthae Piperitae 

" Aurantii Florum " Menthae Viridis 

" Camphorae " Rosae.] 



ARGENTUM— SILVER. 

[Argenti Cyanidum — for making Acidum Hydrocy- 
anicum Dilutum for immediate use. 

Argenti Nitras. Dose, gr. j-ij (.01 to .12 Gm.), in 
pill. 



SILVER. 



147 



Argenti Nitras Fusa — Lunar Caustic, for external 
use. 

Argenti Oxidum. Dose, gr. ss-ij (.03 to .12 Gm.), in 
pill. 

Antidote. 

The chemical antidote to nitrate of silver is table salt, 
which should be followed by an emetic or a purgative. 

Metallic silver is inert. As it occasions no chemical irri- 
tation in the tissues, canulas are made of it for use in empyema 
to wash out the chest, etc. Silver wire is also used in sur- 
gery to unite the fractured ends of bones where there is 
delayed union, and for sutures in wounds of the scalp and 
elsewhere. The salts of silver are best administered in pill 
form, for which gum Arabic is probably the best excipient, 
as with vegetable extracts, or glucose, they are apt to ex- 
plode.] 

Local Action. 



Physiological. 

The nitrate of silver pri- 
marily hardens, but seconda- 
rily destroys, the cuticle, and 
condenses the tissues by co- 
agulating their albumen. 



Its application may cause 
ulceration of the healthy skin, 
and it is often used to check 
the activity of granulating 
surfaces. 



Therapeutical. 

Nitrate of silver, either in 
substance or solution, has 
been used to check the spread 
of erysipelatous inflamma- 
tion ; to arrest the pitting of 
smallpox ; and to avert the 
formation of bed-sores. 

It is a good injection for 
gonorrhoea, or collyrium for 
conjunctivitis, and a strong 
solution is one of our best 
remedies for various relaxed 
or ulcerated conditions of the 
fauces. In substance, lunar 
caustic forms a good applica- 
tion to simple venereal sores, 
ulcerated tonsils, or to any 
ulcerating or granulating tis- 
sue, when we wish to repress 
exuberant granulations or ex- 
cite a new and more healthy 
action. 



148 ARNICA. 

Internal Actions and Uses. 

Silver is now but little employed internally. It formerly 
enjoyed a certain empirical reputation in the treatment of 
epilepsy and other nervous disorders ; but when it was found 
that not only no benefit resulted from its use, but that an 
indelible and peculiarly unsightly bluish-gray discoloration 
was occasionally developed on the skin, it became evident 
that the wisest course in future would be to discard nitrate 
of silver almost altogether as a constitutional remedy. For 
severe gastralgia, which has resisted other modes of treat- 
ment, nitrate of silver is undoubtedly a very effective remedy ; 
and occasionally patients willingly run the risk of disfigure- 
ment in the hope of cure. In one case which I have had the 
opportunity of examining, the man was well pleased to have 
lost in three months his incessant pain at the expense of per- 
manent staining, the bluish color being much deeper on the 
face, from the action of the light, and being almost invisible 
on the gums, throat, and conjunctivae. [The oxide has been 
highly recommended as a nervous sedative, and has been 
used with good results in the treatment of locomotor ataxia. 
It is said, also, to act as a haemostatic in menorrhagia.] 



ARNICA— ARNICA. 

[ The /lowers of Arnica Montanum, U. S. 
Officinal Preparations, U. S. 

Extractum Arnica?. Dose, grs. v-x (.30 to .60 Gm.). 
Emplastrum Arnica? (extract J). 
Tinetura Arnica? (3'nj-Oj); used externally.] 

External Actions. 

If applied to the skin for Some practitioners value 
some time, arnica causes red- arnica highly for the power 
ness and irritation, and in which they believe it to pos- 
some susceptible subjects sess of absorbing bruises and 
most violent erysipelatous relieving sprains. Dr. Gar- 
inflammation, even ending in rod, on the other hand, as- 
death, has resulted. It must serts that any power it seems 
therefore be used with cau- to exercise in dispersing ex- 
tion. travasations of blood is sim- 
ply due to the spirit which 



ARSENIC. 149 

the tincture contains. Dr. 
Phillips, again, tells us that 
the irritating effects never 
follow the use of an aqueous 
solution, which contains none 
of the arnicine or volatile oil. 

Internal Actions. 

The physiological and medicinal actions of arnica can only 
be balanced with difficulty, as the evidence regarding the 
former is very conflicting, and the opinions on the latter cer- 
tainly err in the direction of over-confidence. As it is rarely, 
if ever, used as a medicinal agent save by homoeopathic prac- 
titioners, it does not seem necessary to say more about its 
asserted virtues. 



ARSENICUM— ARSENIC. 

[Acidum Arseniosum. Sublimed arsenious acid in 
masses, U. S. Dose, gr. Jo- 
Officinal Preparations, U. S. 

Arseniei Iodidum. Dose, gr. £ (.008 Gm.). 

Liquor Arseniei et Hydrargyri Iodidi (n^xx 
contains arsenic gr. ^). Donovan's solution. Dose, n^x 
(.60 Gm.). 

Liquor Arseniei Chloridi. (Acid, arsen. gr. iv ad 
fsj.) Dose, r^v (.30 Gm.). 

Liquor Potassii Arsenitis. (Acid, arseniosum, gr. 
iv ad t'iij.) Fowler's solution. Dose, n^v (.30 Gm.). 

Liquor Sodii Arseniatis. (Sodii arseniat. gr. iv ad 
fjj.) Dose, rri,v (.30 Gm.). 

Sodii Arsenias. Dose, gr. T L (.005 Gm.). 

Metallic arsenic is inert, and is not used in medicine. 
Arsenious acid is sometimes termed white arsenic, or, simply, 
arsenic, as in the following remarks. It is a corrosive 
poison.] 

Poisonous Effects. 

Poisoning by arsenic is ushered in by [a metallic taste in 
the mouth, salivation, nausea, fainting, great thirst, and a] 

13* 



150 -ARSENIC. 

burning pain in the stomach, vomiting, diarrhoea. [The 
stools are dark colored and very offensive, the urine scanty 
and high colored. The pulse is weak and often intermits ; 
there is distressing palpitation of the heart, with labored 
respiration and cold sweats. There is prostration, sometimes 
paralysis, and] headache, fever, and disturbed sleep, fol- 
lowed by more acute symptoms and death from collapse — a 
train of symptoms much resembling those met with in cases 
of true cholera. [Such phenomena occurring in the absence 
of any epidemic of Asiatic cholera, and coming on soon after 
eating, in a previously healthy person, should excite suspi- 
cion of arsenical poisoning.] 

After death, there will be the usual pathological appear- 
ances of gastro-enteritis [but without erosion or abrasion, 
and most marked in the stomach, duodenum, and the rectum. 
Sometimes there are no morbid appearances in these situa- 
tions ; for instance, where it has been administered in a 
vaginal injection.] Frequently we find fatty degeneration 
of the heart and muscles, and parenchymatous degeneration 
of the liver, kidneys, etc. [Arsenic may generally be de- 
tected in the liver, or contents of the stomach, by Reinsch's 
or Marsh's Test. 

Antidotes. 

The chemical antidotes to arsenious acid are freshly pre- 
pared hydrated sesquioxide of iron, and magnesia freshly 
calcined. When Fowler's solution has been taken, the 
ferric salts are the antidotes. 

Treatment. 

Abundant draughts of sweet milk, gruel, decoctions of 
starch, or oily mixtures ; tickling the fauces, etc., to induce 
vomiting ; the stomach-pump ; emetics of sulphate of zinc. 
Hydrated sesquioxide of iron, newly prepared, in large doses, - 
is the only reliable antidote. 

The magnesia may be used with advantage, until hydrated 
peroxide of iron can be procured. Having removed the 
poison by vomiting and purging, we afterwards combat any 
inflammatory symptoms by the usual means, and let the pa- 
tient subsist, for a long time, wholly on the blandest diet. 



ARSENIC. 151 



Tests for Arsenic. 



In the solid state it can be sublimed by heat. If mixed 
with charcoal, and heated in a suitable test-tube, deoxi- 
dated arsenic will be obtained in the form of a metallic 
coating inside the tube ; and this mav be reconverted into 
arsenious acid by urging it in various directions along the 
tube with the aid of a minute spirit-lamp flame ; the facets of 
the crystals thus formed (on the cooler situations) will be 
seen in some places with the unassisted eye, but more dis- 
tinctly by means of a four-power lens. 

In solution, ammoniacal nitrate of silver produces a lemon- 
colored (arsenite of silver) precipitate. Ammoniacal sul- 
phate of copper throws down a grass-green {arsenite of 
copper) precipitate. Transmission of sulphuretted hydrogen 
produces a bright yellow {sulphide of arsenic) precipitate. 
Lime-water precipitates a white (arsenite of calcium} pow- . 
der ; but this test is not one to be relied upon. 

Marsh's Test Placed with zinc and diluted sulphuric 

acid in the hydrogen apparatus, the arseniuretted hydrogen 
thence arising, when lighted, will deposit metallic arsenic on 
a piece of glass held within the flame. 

Reinsch's Test. — Acidulate the suspected liquid with 
muriatic acid, and boil copper wire or foil in it for ten min- 
utes. The arsenic is deposited on the copper as a white 
alloy, from which it can be separated as arsenious acid, by 
subjecting the copper, cut into shreds, to a low red heat in 
the bottom of a small glass tube. 

The precipitates referred to, if washed and dried, may be 
treated as directed above for arsenic in the dry or solid con- 
dition. 

In testing suspected matters obtained from the stomach,^ 
these, and in cases of death, the viscera themselves, must be 
cut or broken up, and boiled during, at least, three-quarters of 
an hour : if not sufficiently fluid, add distilled water. Strain, 
add a small quantity of potassa, and again boil during a 
quarter of an hour, and filter. If this liquor manifest either 
alkaline or acid reaction, neutralize with potassa, or with 
acetic acid, as may be required ; then acidulate it faintly 
with hydrochloric acid. The liquor may now be experi- 
mented on with the above tests.] 



152 



ARSENIC. 



Local Action. 



Physiological. 

Externally applied, arsenic 
causes redness and inflamma- 
tion of the skin, followed by 
ulceration and slouching. If 
we wish to use it as a caustic 
we must apply it freely to 
prevent bad results, remem- 
bering that if we produce in- 
flammation of a part we check 
its absorptive powers. 



Therapeutical. 

Arsenic has been employed 
as a caustic in cancer and 
allied diseases ; but not only 
is its action difficult to regu- 
late, but dangerous symptoms 
of poisoning have resulted 
from the very ready way in 
which it is absorbed by the 
skin. As a more gentle form 
of stimulant, however, it is of 
great service in some chronic 
skin diseases, such as lupus. 



Internal Actions and Uses. 



I. On Brain and Nervous 
System — Arsenic has a tonic 
influence on the nervous sys- 
tem generally. 



II. Circulation and Re- 
spiration. — In small doses 
arsenic may stimulate cardiac 
action in a slight degree ; and 
the experience of the arsenic- 
eaters of Styria shows that 
its use improves their wind, 
and enables them to undergo 
great exertion without fa- 
tigue. This fact, which was 
formerly denied, has been 
placed beyond all doubt by 
the observations of Macla- 
gan, who, after seeing an 



I. This may in some mea- 
sure explain its antiperiodic 
properties, for it is well 
known that arsenic is only 
second to quinine in its power 
of arresting the various man- 
ifestations of ague. 

It is also a valuable remedy 
in neuralgia, and chorea may 
frequently be cured by full 
doses. 

II. Arsenic is of service 
in asthma, hay-asthma, per- 
haps by calming irritability 
of the vagus, and some forms 
of chronic bronchitis and 
chronic phthisis, and has been 
found to act well by the in- 
halation of spray. 



ARSENIC. 



153 



arsenic-eater consume his 
dose, detected the presence 
of the metal in the urine. 
Either arsenious acid or or- 
piment is used, and the lar- 
gest dose is said to be 14 
grains, 8 grains having been 
actually eaten in presence of 
a competent witness. It is 
stated, however, that only 
persons of strong constitution 
can bear this habit. 

III. On the Secreting Or- 
gans. — 1. Digestive Tract. 
In small doses arsenic stimu- 
lates the appetite and in- 
creases the digestive powers, 
but if used more freely symp- 
toms of irritation set in, 
which may terminate in gas- 
troenteritis. [Some patients 
cannot take the smallest doses 
without great systemic dis- 
turbance. It is advisable to 
begin with minute doses and 
cautiously increase, watching 
the effect.] 



2. Cutaneous. — Arsenic 
occasionally causes irritation 
and tingling of the skin, and 
even the appearance of ecze- 
matous and occasionally her- 
petic eruptions. 



III. Ringer recommends 
small doses of arsenic — 1. In 
a form of irritative dyspepsia 
with red tongue and promi- 
nent papillae, in the morning 
vomiting of drunkards, and 
in that variety of diarrhoea 
which leads to the evacuation 
of the bowels immediately 
after eating. It is now thor- 
oughly established that the 
inhabitants of Styria eat 
arsenic to the extent of gr. j 
to gr. ij, and thrive on it, 
becoming fat and ruddy, and 
that it is occasionally given 
to horses with the view of 
improving their coats. 

2. In dry scaly affections 
of the skin, such as psoriasis, 
in the dry stages of eczema 
and impetigo, in pemphigus, 
and in lichen, arsenic acts 
most admirably ; but we must 
be careful never to give it 
during the acute stage of any 
skin affection, as in these 
circumstances, it is invariably 
found to aggravate the symp- 
toms. Arsenic is much val- 
ued by Balfour and others 



154 



ARSENIC. 



3. Liver Arsenic in poi- 
sonous quantities causes, like 
phosphorus, fatty or paren- 
chymatous degeneration of 
the liver. 

4. On Urine Nothing; 

special has been described 
[except that the kidneys and 
liver are the principal chan- 
nels for the discharge of the 
poison from the system.] 



in chronic rheumatism, and 
more especially rheumatoid 
arthritis. 



4. Dr. Lauder Brunton re- 
cords an interesting case in 
which arsenic cured albumi- 
nuria in a young man, due 
probably to imperfect pan- 
creatic digestion of albumen. 



Mode of Elimination. 

Arsenic is rather slowly removed from the body by the 
intestines, the urine, and perhaps the bile and the skin. 
Traces have been found in the urine sixteen days after in- 
gestion. 

Mode of Administration, Cautions, etc. 

Persons vary much in their susceptibility to arsenic, and 
we must invariably begin its use with caution, keeping in 
mind that children bear it well, and that a child of five can 
bear with impunity as large a dose as an adult. [Two 
grains of arsenious acid have caused death, according to Dr. 
Taylor.] 

We must also remember that, although the Styrian peas- 
ants can accustom themselves to large and increasing doses, 
the experience of medical practice shows that, after a certain 
time, patients taking this drug are liable to show some of the 
following symptoms : Smarting and itching about the con- 
junctivae, with oedema, pain in the stomach, vomiting and 
diarrhoea, white tongue, and general digestive derangement ; 
and when these indications of " accumulation" occur, it is 
not necessary to suspend the remedy altogether, but merely 
to diminish the dose. 

The probabilities of these unpleasant symptoms are much 
lessened, however, by advising that the dose should always 
be taken after a meal. 

The mode in which arsenic is usually given is in the form 



ASSAF(ETIDA. 155 

of liq. arsenicalis [Fowler's solution — Liq. Potass. Arsenitis, 
U. S.], which is merely a solution of arsenious acid in car- 
bonate of potash flavored with sp. lavand. co., containing 
gr. ss in f5j? and of which the dose is, as a general rule, 
from n^ij to n^v (.12 to .30 Gm.) ; but in some obstinate 
affections, like chronic rheumatic arthritis, it is requisite to 
push the quantity as far as tt^x or even n^xv (.60 to 1. Gm.). 
Being almost tasteless, liq. arsenicalis is best given simply in 
water. 

The liquor arsenici chloridi, sodii arsenias, and ferri arse- 
nias are rarely used ; and the liquor arsenici et hydrargyri 
iodidi [Donovan's Solution], which was supposed to have 
a special influence over syphilitic skin diseases on account 
of its combination of arsenic with iodine and mercury, has 
gone much out of fashion in these days. Dose, 10 to 30 
minims (.60 to 2. Gm.). [The iodide of arsenic is sometimes 
used as an ointment in skin affections — gr. iij to ^j. Simple 
ointment with arsenious acid (gr. j to ^j) has been highly 
recommended as an agreeable substitute for sulphur ointment 
in the treatment of scabies.^ 

R. Hydrargyri chloridi corrosiv. §iiss or 80' Gm. 
Hydrargyri bisulphureti gr- xl " 2 50 " 

Acidi arseniosi 5i " 4! " M. 

S. To be made into a paste with a little water, and then 
applied with a brush. 

Useful in cases of lupus. 

R. Vini ferri f5.j or 

Liquoris arsenicalis Tr\ iij " 

Syrupi aurantii f 5j " 

Aquas anethi ad f§j " 
Pro dosi. 

Useful in eczema, psoriasis, etc. 



4 




Grm. 




20 


u 


4 




a 


32 




a 



ASSAFCETIDA— ASSAFETIDA. 

[A gum-resinous exudation, obtained by incision from the root of 
Narthex Assafoztida, U. S. Dose, gr. v—x (.30 to .60 Grm.). 

Officinal Preparations, U. S. 

Mistura Assafoetidae (5'iv to Oj). Milk of Assafe- 
tida. Dose, fjss-j (16 to 32 Gm.). 

Tinetura Assafoetidae (§ij to Oj). Dose, f 5ss-j (2 
to 4 Gm.). 



156 ORANGE. 

Pilulae Assafoetidae (each gr. iij). Dose, 2 to 4. 
Pilulae Aloes et Assafoetidae (each gr. jj). 
Pilulae G-albani Compositae (assafoetida gr. -|). 
Suppositoria Assafoetidae (each 5 grains, or ni^xv of 
the tincture). 

Emplastrum Assafoetidae.] 

Physiological Action. Therapeutical . 

A good deal of digestive Assafoetida has been used 

disturbance seems to follow and recommended in a con- 

the administration of this siderable variety of affections, 

drug to healthy persons ; but but practically it is now only 

the evidence is too conflicting prescribed in flatulent dys- 

to enable us to lay down any pepsia and in hysteria, where 

exact scheme of its influence its excessively nauseous smell 

on the various functions of and taste are supposed to give 

the body. it an advantage over other 

drills of the same class. 1 



AURANTIUM—ORANGE. 

[Aurantii Amari Cortex. The rind of the fruit of 
Citrus vulgaris. 

Aurantii Duleis Cortex. The rind of the fruit of 
Citrus aurantium. 

Aurantii Flores. The flowers of Citrus aurantium 
and Citrus vulgaris. 

1 Prof. H. C. Wood states that " assafetida is one of the most 
efficient of the so-called antispasmodics, and may be given to fulfil 
the same indications as valerian in functional spasm, in hysteria, and 
nervousness. It differs from valerian in having a much more de- 
cided action upon the mucous membranes. It is an excellent car- 
minative, and in the form of injection is constantly used for the 
relief of tympanites. It also in small doses increases the appetite 
and affords relief in dyspepsia, with flatulent colic and costiveness, of 
the aged or hysterical. As a stimulating expectorant and anti- 
spasmodic, it is useful in whooping-cough and chronic catarrh. It is 
especially efficient in palliating the latter affection as occurring in 
old people, when the difficulty of breathing is paroxysmally in-* 
creased by spasm of the bronchial tubes. In infantile convulsions and 
in severe infantile colic, assafetida enemata (^ij to ^ij of the milk) 
are exceedingly useful and harmless." — Therapeutics, 2d ed., p. 191.] 



OATMEAL. 15* 



Officinal Preparations, U. S. 

Aqua Aurantii Florum. Used as a vehicle. 

Syrupus Aurantii Florum. Used as a vehicle. 

Confeetio Aurantii Cortieis. Used as a vehicle. 

Syrupus Aurantii Cortieis. Used as a vehicle. 

Tinetura Aurantii. Dose, fjj-ij (4. to 8. Gm.). 

Infusum Gentian® Compositum. Dose, f^ss-ij 
(16. to 64. GirO. 

Tinetura Cinchona? Composita. Dose, f3j-ij (4. 
to 8. Gm.). 

Tinetura Gentians Composita. Dose, f£j-iv 
(4. to 16. Gm.).] 

Properties. 

The various preparations of orange require no detailed 
comment, for beyond the fact that those made from the rind 
are mildly tonic in virtue of their bitterness, and that the 
syrup and the orange-flower water are agreeable flavoring 
additions to a prescription, we have no evidence of their 
special therapeutic properties, if any exist. [The volatile 
oil of the flowers, obtained by distillation, is called, in com- 
merce, oil of Neroli, and orange-flower water is hence some- 
times termed Neroli water.] 



[AVENJE FARINA— OATMEAL. 

The meal prepared from the seeds of Avena Sativa, U. S. 

Extensively used as an aliment in the form of gruel. It 
is nourishing and slightly laxative. Three varieties are met 
with in the Middle States, the Ohio, the Canadian, and the 
Scotch oatmeal ; the latter, being imported, brings a higher 
price, and is considered by some to be better, perhaps 
solely on that account. Its taste is less pleasant than the 
others, which are probably equally as good. Thin oatmeal 
gruel, strained and sweetened, forms a valuable and popular 
infants' food.] 



14 



158 CARBONATE OF BARIUM. 



BALSAMUM PERUVIANUM— BALSAM OF PERU. 

[An empyreumatic liquid balsam obtained from Myrospcrmum 
Peruiferum, U. S. 

Dose, f'3ss (2. Gm.) in emulsion.] 
Local Action. 

Peruvian balsam tends to It may therefore be used, 
check copious and unhealthy like myrrh, as an application 
secretions. to foul and unhealthy sores. 

^Constitutional Action. 

Like the other gum bal- It has therefore been pre- 

sams, it acts on the mucous scribed to restrain excessive 

membranes, and more espe- discharges in bronchitis, etc. 
cially on the bronchial tubes. 



BALSAMUM TOLUTANUM — BALSAM OF TOLU. 

[A semi-liquid balsam obtained from Myrospermum Toluiferum, U.'S. 

Officinal Preparations, U. S. 

Syrupus Tolutanus. (Tinct. f^ij to Oj.) Dose, 
f^ss-j (1G. to 32. Gm.). 

Tinetura Tolutana. (gjss in Oj.) Dose, f 5j (4. Gm.). 
Tinctura Benzoini Composita. (Tolu |ss in Oj.)] 

This agreeable preparation is almost exclusively used as 
a flavoring addition to cough mixtures, in the form of the 
syrup. 



[BARII CARBON AS — CARBONATE OF BARIUM. 

Only introduced into the Pharmacopoeia in order to pro- 
vide a source for the — 

Officinal Preparations. 

Barii Chloridum, and 

Liquor Barii Chloridum. Dose, gtt. xx-x-1. 

The symptoms of poisoning by barium chloride or carbon- 
ate are those of an irritant, with vertigo, convulsions, and 
paralysis. Gastric inflammation is found post-mortem. The 



BELLADONNA. 159 

test for baryta is sulphuric acid. Antidotes : sulphate of 
magnesium or sodium, or dilute sulphuric acid, with demul- 
cents, and stomach-pump. 

Internal Effects. 

Barium is only used in medicine in the form of liquor 
barii chloridum, which is recommended by Prof. Gross as 
an alterative in scrofula, particularly in cases distinguished 
by a tumid upper lip.] 



BELLADONNA—BELLADONNA. 

[Belladonnas Folia. The leaves of Atropa Bella- 
donna, U. S. 

Belladonnas Radix. The root of Atropa Belladonna, 
from plants more than two years old, U. S. 

Officinal Preparations, U. S. 

Tinctura Belladonnas. (From the leaves, gij to Oj.) 
Dose, gtt, x-xx (.60 to 1.30 Gm.). 

Extractum Belladonnas. (Inspissated juice of the 
leaves.) Dose, gr. ss-ij (.03 to .12 Gm.). 

Extractum Belladonnas Aleoholieum. (Of the 
leaves.) Dose, gr. ss-ij (.03 to .12 Gm.). 

Extractum Belladonnas Radieis Fluidum. 
Dose, ntij (.12 Gm.). 

Emplastrum Belladonnas. (From the root.) 

Unguentum Belladonnas. (From ext. belladonna?, 

3J m 5J0 

Suppositoria Belladonnas. (From ext. belladonna? 
ale, gr. ss.) 

Atropia. (From the ( Dose, gr. ^L, or hypodermi- 
root.) ■} cally gr. T * ^ (.001 to .0005 

Atropias Sulphas. (Gm.). 

Antidotes. 

Chemical. Fresh animal charcoal, tannin, vegetable 
astringents, and the fixed alkalies. 

Physiological. Opium, Calabar bean, tartrate of anti- 
mony and potassa, and pilocarpin. 

Note. — In the treatment of belladonna-poisoning, the irritating 
emetics, such as mustard, ipecacuanha, and sulphate of zinc, 



160 BELLADONNA. 

should be exhibited to remove from the stomach any excess of the 
poison remaining unabsorbed. Apomorphia might be useful 
hypodermically (gr. -fa, repeated). Purgatives containing the 
chemical antidotes should then be given to neutralize any of the 
drug in the intestines. Symptoms of narcotism should be treated 
as they arise, by artificial respiration, douches, counter-irritants, 
and diffusive stimulants. The physiological antidotes, being 
counter-poisons, should be used with the greatest care.] 

Local Action. 

Belladonna is used externally, on account of its soothing 
properties, in various forms of neuralgic and rheumatic 
pains, in which cases the liniment, applied either alone or 
in combination with chloroform liniment, often gives relief. 
It is also a good application in acute rheumatism, placed on 
cotton-wool and thus encasing the swollen and tender joints. 
Belladonna is also useful, as has been especially pointed out 
by Mr. Heath, in boils and abscesses, where the suppurative 
process may be prevented or even arrested by its use. It is 
also a good application to inflamed piles and fissure of the 
rectum. It is also applied to the skin to check localized 
sweating, to the breast to arrest the secretion of milk, and 
to the neighborhood of the eye to dilate the pupil ; but its 
actions here are so intimately associated with the theory of 
its internal administration, that we will say no more on the 
subject at present. 

Belladonna is very readily absorbed through the unbroken 
cuticle, and symptoms of poisoning have occasionally been 
caused by its local application. 

Internal Administration. 
Physiological Action. Therapeutical Application. 

1. On the Brain After 1. Belladonna may be 

full doses of belladonna, a cautiously used as a hypnotic 

tendency to delirium sets in, when other remedies fail, 

usually of a joyful character, Ringer records an interesting 

and attended by hallucina- case of acute mania in which 

tions and spectral illusions, the heroic dose of gr. j of 

Sleep generally follows. atropia acted well by causing 

sleep. 

2. On the Spinal Cord. — 2. It is used in some spinal 
In frogs this action is very affections in accordance with 
decided, for when atropia is the principles of Dr. Brown- 



BELLADONNA. 



161 



injected below the skin the 
animal is at first paralyzed, 
lying quite motionless, with 
arrested breathing, which 
period of inaction is suddenly 
interrupted in about from one 
to eighteen hours by the oc- 
currence of violent tetanic 
spasms. 

3. Belladonna paralyzes 
the terminal filaments of the 
third nerve supplied to the 
circular or sphincter fibres of 
the iris, and thus allows the 
sympathetic, which rules over 
the radiating fibres, to come 
into unchecked play, and so 
dilate the pupil. At the 
same time we observe a di- 
minution in ocular tension 
and imperfect vision, espe- 
cially for near objects, due to 
paralysis of the power of ac- 
commodation. 

Gubler says that it also 
causes a diminished sensi- 
bility of the cornea and 
retina, with prolonged reten- 
tion of images by the retina. 
He is rather inclined to be- 
lieve that it has some special 
action on the muscular tissue 
of the iris. 



Sequard, explained under 
another section. 

It is also of value in check- 
ing the tendency which occa- 
sionally exists to nocturnal 
seminal emissions, when these 
become 
quency. 



of exhausting fre- 



14 



3. Belladonna, used more 
conveniently in the cleaner 
form of atropia, is in very 
extensive use in eye diseases 
to facilitate ophthalmoscopic 
examinations, to keep the 
pupil freely dilated in iritis, 
and so lessen the risk of ad- 
hesion of its free margin to 
the lens, with subsequent 
contraction, distortion, and 
impairment of vision. 

It is also used to obviate 
protrusion of the iris through 
any hole in the cornea made 
by ulceration or accident, 
and it forms a soothing ap- 
plication in various painful 
affections. 

To dilate the pupil the liq. 
atropise [Br., gr. iv ad f Jj] 
is now generally used, care 
being taken only to introduce 
a very small drop into the 
eye ; for if a larger quantity 
is applied, the resulting effects 
and inconveniences, more es- 
pecially the paralysis of ac- 
commodation spoiling the eye 
for near work, may last from 
a week to twelve days, much 
to the annoyance of the pa- 
tient. [Although weaker sor 

lutions take a little longer 

* 



1G2 



BELLADONNA. 



4. The action of bella- 
donna on the sympathetic 
nervous system is somewhat 
irregular, and to this is no 
doubt due some at least of 
that action on certain secre- 
tions which we shall shortly 
note more fully. But one 
symptom often observed, 
more especially in children, 
probably proceeds from vaso- 
motor paralysis, and that is 
transient flushing and sweat- 
ing of the face now and then 
following a dose. 

5. The influence of bella- 
donna on the circulation is 
due to another nervous influ- 
ence. Under the use of this 
drug we observe increased 
rapidity and force of cardiac 
action, and this is explained 
by a paralyzing action which 
it exerts on the terminal in- 
hibitory filaments of the 
pneumogastric nerve distri- 
buted to the intimate struc- 



time to dilate the pupil and 
paralyze the accommodation, 
yet these effects are more 
transient and therefore more 
satisfactory to the patient. 
A gr. \ solution is strong 
enough for ordinary use, and 
will dilate the pupil in about 
half an hour after instilla- 
tion.] 

Belladonna being so read- 
ily absorbed, however, dila- 
tation of the pupil will ensue 
on application of the extract 
or liniment for any length of 
time to any part of the body. 



5. Belladonna is an excel- 
lent cardiac tonic, increasing 
the regularity and strength 
of the- contractions of the 
heart. 

It is also a very soothing 
remedy in cases of irritable 
palpitation, and the old- 
fashioned belladonna plaster 
is certainly of use in these 
conditions. 



BELLADONNA. 



163 



ture of the heart, as well as 
on the nerve itself, thus dif- 
fering from curare, which 
only effects the trunk of the 
nerve. It is proved by ex- 
periment that the sympathetic 
nerve supply has the power 
of causing very rapid action 
of the heart ; but a rein is 
kept on this, and the proper 
balance of motive force is 
sustained by the pneumogas- 
tric nerve, which inhibits or 
restrains the impetuous action 
of the sympathetic. By 
paralyzing these inhibitory 
filaments, then, belladonna 
hands the heart over to the 
sympathetic, which, without 
rein or drag, runs riot, and 
we accordingly find that ex- 
cessive increase in the heart's 
rapidity follows the injection 
of a moderate quantity of 
atropia. 

Coincident with this we 
get raised arterial tension. 

6. Belladonna contracts 
the small vessels, probably 
not from nervous influence, 
but from a direct action upon 
the unstriped muscular fibres 
surrounding the arterioles. 



6. Dr. Brown-Sequard re- 
commends the use of bella- 
donna in those cases of chro- 
nic inflammation of the spine 
leading to paralysis, where it 
acts well by contracting the 
vessels and diminishing the 
supply of blood to the affected 
part; and he gives it inter- 
nally, and applies a plaster 
along the spine. 

To this contracting influ- 
ence on the small vessels is 
probably due the effect of 
belladonna in checking local 
inflammatory conditions. 



164 



BELLADONNA. 



7. On Respiration — Bel- 
ladonna tends to increase the 
rapidity of the breathing by 
stimulation of the respiratory 
centre. 

8. It has the power of con- 
tracting unstriped muscular 
fibre in other situations than 
the arterial tubes. It proba- 
bly does so both in the blad- 
der and intestines. 



7. Atropia has been re- 
commended as an efficient 
remedy in asthma. 



8. Belladonna is an excel- 
lent remedy for the nocturnal 
incontinence of urine of 
children : but in order to do 
any good it must be boldly 
pushed, and I have been 
obliged to give as much as 
f5Jss or even f3ij of the 
tincture [Ph. B.] before suc- 
cess Aviis attained. 1 

From its tonic influence 
on the muscular structures of 
the intestines, it is an excel- 
lent adjunct to purgative pill 
masses, from \ to -J grain 
acting well in combination 
with colocynth ; or, even 
given alone with ext. gen- 
tiame, it will often secure a 
regular action of the bowels. 

It is also very useful by 
relieving spasm, as in colic, 
and intestinal obstruction has 
occasionally yielded to large 
doses. 

9. Belladonna has been 
used to check excessive sali- 
vation. 



Action on Secretion 9. 

Salivary It checks the sa- 
livary secretion, causing a 
peculiar sensation of dryness 
in the mouth and throat; and 
this is believed to be due to 
a remarkable selective action 
on the secretory branches 
supplied from the chorda tyrn- 
pani nerve to the submaxil- 
lary ganglion. 



1 [The Tincture of Belladonna, U. S., is about 2£ times the 
strength of the English preparation.] 



BELLADONNA. 



165 



10. Cutaneous. — Bella- 
donna most effectually arrests 
the action of the skin, and 
occasionally under its use a 
vivid red eruption, not unlike 
scarlet fever, breaks out. 



11. If also checks the se- 
cretion of the milk, either 
locally or by internal use. 



10. It is an excellent rem- 
edy for undue sweating, whe- 
ther general, as in phthisis 
(as originally recommended 
by Bartholow in 1869) 1 or 
rheumatism, or local, as about 
the head of rickety children 
or the feet of some individuals. 
It may be either given in the 
form of succus, extract, or 
tincture, or better by the 
subcutaneous injection of 
atropia. 

11. It is a most valuable 
remedy in cases where in- 
flammation threatens in a 
breast, when the child, has 
died or cannot suck, and the 
gland becomes congested 
from retention of its secre- 
tion. Here the external 
application of belladonna 
speedily diminishes the red, 
tense, shining aspect, relieves 
the wearing pain, and arrests 
the milk. 

12. It may * therefore be 
recommended as a good di- 
uretic. 



12. On the solid urinary 
constituents no special action 
has been noted, but it in- 
creases the flow, by raising 
the tension in the glomeruli 
of the Malpighian bodies. 



Belladonna is also used under one or two conditions which 
cannot accurately be grouped under any specific heading. 

Thus it has been vaunted in whooping-cough, but after 
careful and repeated trials with large and small doses, I am 
compelled to agree with Dr. Kelly that its action in this dis- 
ease is too uncertain to be of much use. But in certain forms 



C 1 To Da Costa, unquestionably, belongs the" credit of having 
first demonstrated the value of atropia in checking excessive sweat- 
ing in phthisis.] 



166 BELLADONNA. 

of spasmodic cough, simulating pertussis, or when the cough 
is merely an occasional, loud, clanging bark, I have derived 
much benefit from belladonna. In epilepsy and chorea it 
has been tried, but without marked success. [As a prophy- 
lactic against scarlet fever, belladonna has attained consider- 
able reputation, perhaps undeservedly. It is to be given in 
small doses, continued twice or thrice daily until danger is 
over.] 

The subcutaneous injection of atropia is said by Dr. Anstie 
to be of great service in lumbago, sciatica, and chronic rheu- 
matism, and to be the best of all remedies for pain in the 
pelvic viscera. It has also been recently observed that the 
addition of a little atropia to the ordinary morphia injection 
tends to obviate the distressing faintness, pallor, and nausea 
which occasionally mar the efficacy of the subcutaneous mode 
of administering this valuable drug. Ringer recommends 
its use in irritative dyspepsia, giving from \ to \ gr. of the 
extract night and morning, and gradually increasing the 
dose. [A solution of atropia, 1 in 100, if applied to an ex- 
posed nerve-pulp, is said to relieve toothache immediately.] 

Drawbacks to the Use of Belladonna. 

Poisonous Symptoms and Antidotes. — Occasionally the 
use of atropine drops to the eye causes an erysipelatous in- 
flammation about the lids and face, and patients often com- 
plain of the disfigurement and inconvenience arising from a 
widely- dilated pupil. Liebreich (St. Thos. Hosp. Rep., 
vol. vii.) points out that the poisonous symptoms of atropia 
are occasionally developed by its introduction into the eye, 
.and that they are due, not so much to absorption by the con- 
junctiva as to the fluid trickling through the lachrymal ducts 
into the nose, throat, and stomach. This may be avoided by 
telling the patient to rinse his throat occasionally. He also 
notes conjunctivitis, erythema, eczema, and peculiar pearly 
granulations on the conjunctivae from the long-continued use 
of these drops. Minor degrees of belladonna poisoning, how- 
ever, need give us no uneasiness. Idiosyncrasy may also 
here be the source of inconvenience, and we may find persons 
affected with dryness of the mouth and throat after very 
small doses. This is always the first indication of the phy- 
siological action of belladonna, and is followed by a peculiar 
sensation of thirst and feverishness, without heightened tern- 



BELLADONNA. 167 

perature, rapid pulse and breathing, red tongue ; the face 
then flushes, delirium sets in, with great weakness, very hur- 
ried breathing, convulsions, and finally coma, which ends the 
scene. The antidotes are opium, which, within certain 
limits, is antagonistic to belladonna, animal charcoal, the 
fixed alkalies, which destroy its poisonous properties, and 
Calabar bean, which has recently been shown to be the phy- 
siological antidote. A direct physiological antagonism has 
also been shown to exist between atropia, muscarin, and 
jaborandi, or pilocarpine, which stimulate the intracardiac 
inhibitory apparatus, and slow the heart. 

One curious point about belladonna is that, although so 
poisonous to man, its destructive influence is very various on 
other animals. The carnivora are much more readily affected 
by it than the herbivora, many of whom browse on it with 
impunity. Thus a horse has been known to eat eight pounds 
of the leaves without injury ; blackbirds feed freely on the 
berries ; and 15 grains of atropia are required to poison a 
rabbit. 

Dose and Mode of Administration. 

Atropia may be given in phthisical sweating, in pill, in 
doses varying from ¥ -L grain (Bartholow) to gr. T V to ^ 
[Da Costa] ; but it is not very often used internally. 

It is well to note that children take not only without in- 
jury, but with benefit, much larger doses than adults, and, 
whilst I have seen a woman display well-marked physiolo- 
gical symptoms after a few 10-minim doses, I have often 
prescribed 20 minims of the [English] tincture for a child of 
two years without anything of the kind. 



Asthma Cigarrettes. 



U 



Belladonna? fol. 


gr. xcvj ; or 


(appr 


oximately) 6 


50 Gm 


Hyoscyami fol., 












Stramonii fol., lia 


gr. xlviij ; 




or 


3 


25 " 


Ext. opii 


gr. iv ; 




a 




25 " 


Tabaci fol. 


gr. lxxx ; 




a 


5 


30 " 


Aquae 


Oj; 




a 


500 


it 


infusion et add — 










Potass, nitrat. 


3ij B ; 4 ; 




or 


10 


70 Gm 


Potass, arsenitis 


3v £j ; 




it 


21 


30 " 



Ft. 



M. S. Saturate sheets of bibulous paper in this solution, 
dry and roll them, and use for fumigation as directed. 

Phil a. Hosp. 



168 



BENZOIN. 



BENZOINUM— BENZOIN. 

[^1 solid balsam obtained from Styrax Benzoin, U. S. 
Officinal Preparations, U. S. 

Aeidum Benzoieum. (Enters into Tinctura Opii 
Camphorata.) Dose, gr. x-xxx (.60 to 2. Gm.). 

Ammonii Benzoas. Dose, gr. x-xxx (.60 to 2. Gm.). 

Tinctura Benzoini. Dose, i'3ss-f3j (2. to 4. Gm.). 

Tinctura Benzoini Composita. Dose, f5j-ij (4. 
to 8. Gm.). . 

Unguentum Benzoini. (Adeps Benzoatus, Br.)] 



Local Action. 

Physiological. 

Tincture of benzoin is a 
stimulant to raw surfaces. 
[Benzoin has the property 
of preventing rancidity in 
ointments, etc., in hot 
weather.] 



Therapeutical. 

It is therefore occasionally 
used as an application to foul 
or indolent sores. [The com- 
pound tincture of benzoin is 
a useful application to cracked 
nipples.] 



Internal Action. 



Benzoin has the stimulat- 
ing influence on mucous 
membranes possessed by most 
of the gum-balsams. During 
its passage through the blood 
it becomes converted into 
hippuric acid, and increases 
in some measure the acidity 
of the urine. 



Benzoin may be prescribed 
with effect in advanced cases 
of bronchitis, and in some 
conditions of chronic irrita- 
tion about the bladder. 

It may be conveniently 
given in the form of the ben- 
zoate of ammonia. 



&. Tinctiu-a? benzoini composite f.^vj; or 24 1 Gm. 
Mucilaginis acacise f ^j ; " 32; " 

Syrup i zingiberis f §ss ; " 16 j " 

Aqua? mentlise piperita? f fvj ; " 1921 " 

S. Capiat unciam unam quarta quaque liora. * 

For advanced bronchitis. 



M. 



BISMUTH. 



169 



[OLEUM BERGAMII—OIL OF BERGAMOT, 

The volatile oil obtained from the fruit of Citrus Limetta 
(De Candolle), U. S. 

Used almost exclusively as a perfume.] 



BISMUTHUM—BISMUTH. 

[ Commercial bismuth of good quality, U. S. 

Officinal Preparations, U. S. 

Bismuthi Subearbonas. Dose, gr. xv-xlv (1. to 3. 
Gm.). 

Bismuthi Subnitras. Dose, gr. v-xxx (.30 to 2. 
Gm.).] 

Local Action. 



Physiological. 

Bismuth has no action on 
the unbroken cuticle, but ap- 
plied to a raw or mucous sur- 
face, it is sedative and astrin- 
gent. 



Therapeutical. 

It is a good application to 
intertrigo, ulceration about 
the mouth, and as an injection 
in gonorrhoea and leucor- 
rhosa. It has lately been re- 
commended as a snuff to check 
cold in the head, and the li- 
quor has been praised as an 
application to prolapsus ani 
(Cleland). 



Internal Actions and Uses. 



On Digestive Tract Bis- 
muth is sedative to the sto- 
mach, and exerts an astrin- 
gent influence over the intes- 
tines, probably in virtue of 
its local effects. [In large 
doses, the subnitrate of bis- 
muth has caused fatal gastro- 
enteritis.] 



15 



Bismuth is one of our most 
valued remedies in many 
forms of dyspepsia, the main 
indications for its use being 
pain and vomiting. When a 
patient suffers acute pain after 
eating, with or without sick- 
ness, the tongue being clean 
and much flatulence present, 
we may give bismuth with 
much confidence, and it is 



170 BROMINE. 

also of service in the vomit- 
ing of drunkards, in pyrosis, 
and in many forms of diar- 
rhoea, more especially that 
met with in children. 

Mode of Elimination. 

Very little bismuth is absorbed, and it is principally thrown 
out of the system by the intestines, to whose secretion it im- 
parts a blackish hue, from the formation of a sulphide. 

Mode of Administration, etc. 

The subnitrate of bismuth, which is the most effective pre- 
paration, may be given simply in powder, either by itself or 
in combination with charcoal or soda ; or it may be given in 
solution with hydrocyanic acid, or infusion of gentian ; mode- 
rately large doses being preferable. 

B_. Bismuthi subnitratis 
Mucilaginis acacia? 
Acidi hydrocyanici diluti 
Infusi gentiaiise 

S. Sumat f 5ss ter die. 



5ij; 


or 


8 


Gm. 


f 3j ; 


a 


32 


n 


n\,x-xx ; 


a 




60 " 


ad f Jvj ; 


a 


192 


a 



M. 

Gm. 



R.. Liquorisbismuthiet ammonia? citras [Br.] f3iv ; or 16 

Syrupi aurantii 

Infusi calumbse, aa f§v ; " 160 

Misce. Sumat unciam unam ter in die. 

The carbonate and oxide of bismuth are seldom us'ed, but 
an agreeable preparation, less effectual, however, than the 
subnitrate, is known as the liquor bismuthi et ammonioe 
citratis (which contains gr. iij of the oxide to the drachm), 
and lozenges (containing each gr. ij of the subnitrate) are 
also included in the British Pharmacopoeia. 



BROMINIUM-— BROMINE. 

[A liquid, non-metallic element, obtained from sea-water. 

Dose, gtt. ij-iij (.12 to .20 Gm.), largely diluted with 
water. 

Officinal Preparations, U. S. 

Ammonii Bromidum. Dose, gr. xx-xxx (1.30 to 2. 
Gm.). 

Potassii Bromidum. Dose, gr. x-3j (.60 to 4. Gm.). 



BUCHU. 171 

Antidote. 

Ammonia, followed by the customary treatment for irri- 
tant poisons.] 

Bromine has been used as a lotion by Dr. Routh and 
others [and in olive oil (n\,x to jfj) it is said to be a specific 
for the eruption of poison-ivy, rhus toxicodendron^. 

Bromine being never used to any extent in medicine, we 
shall consider its properties under Bromide of Potassium. 

[Bromine is a valuable caustic, and is sometimes used in 
gynaecology as an application to the uterus. It is said that 
its mixture with glycerine and alcohol is liable to explode. It 
is useful in hospital gangrene both as a caustic, and in dilute 
solution as an antiseptic wash. Used internally, it resembles 
iodine in its effects as an alterant.] 



BUCHU— BUCHU. 

[ The leaves of Barosma Crenata and other species of Barosma, U. S. 
Officinal Preparations, U. S. 

Extraetum Buehu Fluidum. Dose, f'5ss-j (2. to 
4. Gin.). 

Infusum Buehu (faj to Oj). Dose, f 3J— ij (32. to 
54. Gm.).] 

Physiological Action. Therapeutical. 

The physiological action Buehu has long been val- 

of buehu is principally if not ued by surgeons as a useful 

entirely expended on the remedy in chronic catarrh of 

mucous membrane of the* the bladder and the various 

genito-urinary organs. It is mucous discharges from the 

probable that the volatile oil genito-urinary organs de- 

which it contains, being rap- pending on a relaxed condi- 

idly taken into the blood and tion of the affected parts, 

as rapidly excreted by the [It is largely employed in 

kidneys, acts locally through the treatment of subacute 

the urine on the lining mem- or chronic gonorrhoea, re- 

brane of the bladder aid sembling turpentine in its 

urethra. [It is also, to some effects, although far lessstim- 

extent, diaphoretic] ulating. In incontinence or 

The urine is impregnated retention of urine, depend- 



172 CADMIUM — COFFEE. 

with the peculiar odor of the ing upon want of tone in the 
drug, and is perhaps slightly bladder, it is a most useful 
increased in quantity. agent.] 



CADMIUM— CADMIUM. 

Officinal Preparation. 

Cadmii Sulphas. Used externally. 

The sulphate of cadmium strongly resembles the cor- 
responding zinc salt in its properties, and is occasionally 
employed as an astringent collyrium (gr. i-iv to rose-water 
fsj). The iodide of cadmium is officinal in the British 
Pharmacopoeia, but is only used in the form of unguentum 
cadmii iodidi [Br., gr. lxij to 3J] in some cases of skin dis- 
ease [making an admirable substitute for the iodide of lead]. 



CAFFEA— COFFEE. 

[ The seed of Caffea Arabica, U. S. ] 

Tea, coffee, guarana, and coca, substances containing the 
same alkaloid, caffeine, have much the same effect. 

CAFFEINE 

is a very active substance, causing at first increase, but later 
diminution, of the reflex functions of the cord, with nervous 
convulsions and muscular rigidity, the motor nerves not 
being affected. The heart's action is at first accelerated, but 
afterwards retarded. The excretion of urea is lessened. 
The frequent and prolonged use of tea and coffee causes, in 
some persons, a variety of nervous sensations, sleeplessness, 
numbness, and tingling of the extremities, with irritability 
of the heart ; and there is no doubt that much loss of appe- 
tite and flatulent dyspepsia originate in the habit of drinking 
tea shortly before or after meals. The invigorating and re- 
storative effects of tea and coffee are well known, and valued 
by persons undergoing much bodily fatigue. The therapeutic 
indications for tea and coffee are almost restricted to the 
administration of the latter substance in cases of opium- 
poisoning. 

Guarana in gramme doses has been found a useful remedy 
for migraine or sick headache, and the chewed leaves of the 






OIL OP CAJUPUT — CALCIUM. 173 

coca plant have been highly recommended by Sir K. Chris- 
tison and others as a nervine and muscular stimulant. 
Although the respected baronet found great benefit from this 
plant during severe exertion, Weston, the well-known pedes- 
trian, gives his opinion as tending quite to the opposite con- 
clusion. 



[OLEUM CAJUPUTI— OIL OF CAJUPUT. 

The volatile oil obtained from the leaves of Melaleuca Cajuputi 
{Roxburgh, Trans. LoncL Medico-Botan. Socy.), U. S. 

Cajuput oil is highly prized in the East Indies as a stimu- 
lant carminative. The ordinary dose is gtt. ij— v (.12 to .30 
Gm.), but it has been given with great success in the col- 
lapse of cholera, in doses of gtt. xv to f 3j (1. to 4. Gm.). It 
is also used as a rubefacient and counter-irritant, diluted 
with olive oil. Like other oils of this class, it relieves tooth- 
ache when introduced into a carious tooth.] 



CALCIUM—CALCIUM. 

[Caleii Chloridum — Chloride of calcium prepared by 
fusion, U. S. 

Caleii Hypophosphis — Hypophosphite of lime. Dose, 
gr. x-xxx (.60 to 2. Gm.). 

Calx — Lime recently prepared by calcination, U. S. 

Calx Chlorinata — A compound resulting from the 
action of chlorine on the hydrate of calcium and containing 
at least 25 per cent, of chlorine, U. S. 

Officinal Preparations, U. S. 

Caleis Hydras. Used in pharmacy. 

Caleii Carbonas Praeeipitata. Dose, gr. xx-5j 
(1.30 to 4. Gm.). 

Caleii Phosphas Praeeipitata. Dose, gr. x-xxx 
(.GO to 2. Gm.). 

Creta Praeparata. Dose, gr. x-xv. (.60 to 1. Gm.). 

Hydrargyrum cum Creta (mercury 3 pts., chalk 
5 pts.). Dose, <rr. v-xxx (.30 to 2. Gm.). 

Trochisei Cretan. 

Mistura Cretan. Dose, fgss (16. Gm.). 

Testa Praeparata. Dose, gr. x-xv (.60 to 1. Gm.). 

15* 



174 



CALCIUM. 



Liquor Caleii Chloridi. Dose, ttlxxx (2. Gm.). 

Liquor Calais (lime-water). Dose, f5j-iv (4. to 
16. Gm.). 

Linimentum Caleis (lime-water f^viij, linseed oil 
fJvij). 

Potassa cum Calce (Vienna Paste). Used as a 
caustic. 

Also used in the preparation of -ZEther Fortior, Ammonii 
Valerianas, Aqua Ammoniae, Liquor Potassae, Liquor Sodae, 
Liquor Sodae Chlorinate, Quinine Sulphas, Santoninum, 
Spiritus Ammoniae, Strychnia, and Sulphur Praecipitatum.] 

Local Action. 



Physiological. 

Some of the preparations 
of lime, used externally, are 
sedative or soothing ; others 
are astringent. 



Therapeutical. 

Lime is used as a soothing 
application to burns, as in 
the linimentum caleis ; and 
lime-water makes a good 
injection for leucorrhcea, or 
enema for the destruction of 
thread-worms. 

[In croup and diphtheria, 
great relief is afforded by 
breathing the vapor of slaking 
lime, or simply atomized lime- 
water.] 



Internal Uses. 



Lime, taken internally, 
neutralizes acid secretions, 
and has astringent proper- 
ties. 



It is therefore used with 
benefit in some forms of dys- 
pepsia and in diarrhoea, 
liquor caleis being the most 
generally employed prepara- 
tion. Lime-water is also of 
great service in preventing 
the curdling which often 
causes milk to disagree with 
patients of weak digestion. 

Chalk is more astringent than lime, and is an excellent 
remedy, either alone or in combination with opium, for 
diarrhoea. 



COLUMBO. 115 

Chloride of calcium has been highly praised as a remedy 
for various forms of scrofula. [The dose of fused chloride 
of lime (not calx chlorinata) is gr. x-xx (.60 to 1.30 Gm.), 
but it is rarely prescribed.] 

Phosphate of lime has been highly praised by Ringer in 
doses of gr. j to ij (.00 to .12 Gm.) in rickets, where it acts 
by improving the general nutrition of the system, and sup- 
plying structural elements in which the growing bones of 
badly nourished children are often deficient ; the best time 
for administration being after the cessation of the acute period, 
when all tenderness has subsided. It is also of service in 
anaemia, general debility, tubercular diarrhoea, etc., and the 
dose must never exceed gr. j to ij, more than which will not 
be absorbed. [The hypophosphite of lime has been highly 
recommended in consumption. 

The sulphide of lime is considered to be very useful in the 
furuncular diathesis, when boils appear in crops. Ringer 
gives gr. -^ every hour, at first ; subsequently a larger dose 
may be given less frequently. It is also used in scrofula 
and chronic ulcers.] 



CALUMBA— COLUMBO. 

[The root of Jateorrluza pahnata (Miers), Coccalus pahnatus (De 
Cancfolle) ; and Jateorrhiza Calumba (Miers), Coccidus pahnatus 
(Wallich Catal. non D. C), U. S. 

Officinal Preparations, U. S. 

Extr actum Calumbae Fluidum. Dose, n^xv-xxx 
(1. to 2. Gm). 

Infusum Calumba? (root f^ss to Ojj. Dose, f Si-ij 
(16. to 32. Gm.). 

Tinetura Calumbae (root Jij to OjV Dose, f3j-ij 
(4. to 8. Gm.).] 

Local Action. 
Calumba has no local action. 

Constitutional Action. 

Physiological. Therapeutical. 

On the Digestive Func- Calumba is a good tonic 

tions — Like all bitter tonics, in deficient appetite from in- 



176 



CAMPHOR. 



calumba stimulates the appe- 
tite, and increases slightly 
the secretion of saliva and 
the gastric juice. It is lighter 
and more agreeable than 
some others of the class, and 
has been believed to have 
sedative properties, in virtue 
of which it may be bene- 
ficially given in sickness and 
vomiting ; but of this we 
have been unable to obtain 
reliable evidence. 



digestion or simple want of 
tone, in various dyspeptic 
conditions, and in most en- 
feebled states of the consti- 
tution, from whatever cause 
they may arise. [As it does 
not contain tannic acid, it 
may be given in combination 
with iron.] 



Mode of Administration. 

Calumba is usually given in combination either with iron, 
with alkalies, or with other tonics. Thus : — 



or 



I£. Ferri et potassii tartratis 3jss ; 
Potassii bicarbonatis ^ij ; 

Syrupi hemidesmi [Br.] f§j ; 32 

Infusi oalumbse f|vij ; " 224 

Misce, fiat mistura. Capiat unciam unam bis in die. 



Gin. 



$■ 


Pulveris ealunibse 


gr. 


x ; 


or 




60 Gin 




Sodii bicarb. 


gr. 


xx ; 


a 


• 1 


30 " 




Pnlv. rhei 


gr. 


v; 


a 




30 " 




Pulv. zingiberis 


gr. 


x; 


a 




60 " 



M. Fiat pulvis bis in die sumendus ante cibuin. 
A useful powder in some forms of dyspepsia. 



C AMPHORA— CAMPHOR. 

[A peculiar, concrete substance, derived from Camphora officinarum, 
and purified by sublimation, U. S. 

Dose, in substance, gr. i-ij (.06 to .12 Gm.). 

Oleum Camphorae (Oil of Camphor). Dose, gtt. 
ij-iij (.12 to .20 Gm.). 

Officinal Preparations, U. S. 

Aqua C amphorae (3j to Oj). Dose, fgss-ij (16. to 
64. Gm.). 

Linimentum Camphors (camphor 1 pt., olive oil 
6 pts.). 



CAMPHOR. 



177 



Linimentum Saponis. 

Mistura Chloroformi (chloroform fsss, camphor 5j 
in f^vj). 

Spiritus Camphorae (fgij to Oj). Dose, f 5ss-j (2. 
to 4. Gm.). 

Tinetura Opii Camphorata (Paregoric). Dose, 
f*ss (16. Gm.). 

Ceratum Plumbi Subaeetatis (Goulard's Cerate). 

Antidotes. 
Opium and stimulants.] 

Local Effects. 
Physiological. Therapeutical. 

Camphor has some rube- Camphor forms an ingre- 
facient properties, reddening dient of most of the lini- 
and irritating the skin. ments in common use. 



Internal Action. 



1. Brain and Nervous 

System Camphor in large 

doses causes a good deal of 
giddiness and confusion of 
ideas, even amounting in 
some cases to delirium. 

Muscular weakness is at 
first observed, but this rap- 
idly gives way to violent epi- 
leptiform convulsions and 
almost maniacal excitement. 
In frogs, well-marked lower- 
ing of the reflex irritability 
of the spinal cord has been 
observed. 

2. Circulation — In small 
doses camphor seems to stim- 
ulate the heart's action, but 
after the administration of 
larger quantities great car- 
diac prostration has been ob- 



1. Camphor is not used 
[in large doses] on account 
of its action on the nervous 
system, and the results of the 
few experimenters who have 
been bold enough to try the 
effects of large doses on them- 
selves have not been of a 
very encouraging nature. [It 
is moderately stimulating and 
diaphoretic, and possesses un- 
doubted anodyne and narcotic 
influence. In the spasmodic 
and nervous complaints of 
women camphor is exten- 
sively employed.] 

2. Camphor has been found 
of service in the early stages 
of coryza, but must be here 
used with caution, as the 
homoeopathic tincture, which 
is sometimes prescribed out- 



IIS 



CAMPHOR. 



served by Dr. Geo. Johnson 
and others. 



3. Respiration and Tem- 
perature. — No influence on 
the respiration is noted, but 
there is a marked lowering 
of temperature. 

4. Digestive and Secreting 
Organs. — In large doses, 
some irritation of the gastro- 
intestinal mucous membrane 
has been observed, with dia- 
phoresis, and the sexual ap- 
petite seems to be diminished. 



side of the regular profession, 
is now known to be a very 
strong preparation, and Dr. 
Geo. Johnson and others have 
described cases in which ex- 
cessive weakness and faint- 
ness, with great cardiac and 
muscular prostration, fol- 
lowed doses of from 15 to 
20 minims [and several fatal 
cases of poisoning by it have 
been reported]. 



4. Camphor is said to be 
a good remedy in summer 
diarrhoea. 



It is a popular antidote in 
chordee. 



Administration. 

The bromide or monobromide of camphor has been highly 
recommended in nervous palpitation and irritation of the 
genito-urinary organs, and it also has the power of lowering 
the bodily tempeiature. 

[The combination of camphor with opium and acid forms 
an exceedingly useful mixture for the treatment of acute 
dysentery, following a chilling of the general cutaneous 
surface. 



Hope's Camphor Mixture. 



R. Acid, nitrosi ,^j ; 

Tinct. opii deod. TT^xl ; 

Aquae camphorse q. s. ad §\*iij. 
Dose, £ part, after each evacuation.] 



or 



4 

2 
256 



Gra. 



60 



M. 



CANELLA — INDIAN HEMP. 179 

[CANELLA—CANELLA. 

The bark of Canella alba, U. S. 

Officinal Preparations, U. S. 

Pulvis Aloes et Canellae (aloes 12, canella 3 parts). 
Dose, gr. x-xx (.60 to 1.30 Gm.). 

Vinum Rhei (rhubarb gij, canella 3J 5 to Qj). Dose, 
f 3j_iv (4. to 16. Gm.). 

Uses. 

Canella is an aromatic tonic, but is rarely prescribed alone. 
It contains no tannin, and may be given with a chalybeate. 
The powder of aloes and canella is a popular remedy for 
amenorrhcea under the title of Hi era Picra.] 



[CANNA— CANNA. 

The fecula from the rhizome of an undetermined species of Canna, U. S. 

Canna-starch may be used like arrowroot as a bland 
nourishment for invalids.] 



[CANNABIS AMERICANA—AMERICAN HEMP. 

The flowering tops of Cannabis Sativa, cultivated in North 
America, U. S. 



Officinal Preparation, U. S. 

im Cann 
to J (.015 to .03 Gm.).] 



Extraetum Cannabis Americana^. Dose, gr. \ 



CANNABIS INDICA—INDIAN HEMP. 

[ The flowering tops of the female plant of Cannabis Sativa, 
variety Indica, U. S. 

Officinal Preparations, U. S. 

Extraetum Cannabis Indieae. Dose, gr. \ (.03 
Gm.). 

Tinetura Cannabis (gr. iij ad f3j). Dose, gtt. x-xx 
(.60 to 1.30 Gm.).] 



180 



INDIAN HEMP. 



Local Action. 
Indian hemp is never used locally. 

Internal Actions. 



Physiological. 

1. On Brain and Nervous 
System — Indian hemp, like 
opium, possesses a double 
exciting and sedative action, 
the brain being stimulated 
into pleasant exhilaration be- 
fore sleep sets in. This pre- 
liminary effect, however, is 
more powerful and lasting 
than in the case of opium, 
and the subsequent condition 
of slumber is usually dis- 
turbed by dreams and spec- 
tral illusions. Various au- 
thors have given graphic de- 
scriptions of the intellectual 
disturbance produced by this 
drug, dwelling more especi- 
ally on a peculiar feeling of 
double consciousness, leading 
on, in some cases, to partial 
catalepsy. 

We also find indications 
of some special affection of 
the sensory nerves, a marked 
degree of numbness and ting- 
ling, ushering in cutaneous 
anaesthesia and diminution of 
the muscular sense. 

2. Circulation. — Some in- 
creased rapidity of pulse has 
been observed during the ac- 
tion of Indian hemp ; but it 
is probable that this is only 
due to the condition of nerv- 



ier ajomfo'ca/. 

1. Indian hemp may be 
used as a narcotic when other 
remedies fail ; but its action 
is so uncertain and irregular, 
and the difficulty of procur- 
ing reliable preparations so 
great, that our present know- 
ledge does not enable us to 
lay down any practical rules 
for its employment. Dr. 
Clouston, however, has ob- 
tained valuable assistance in 
acute mania by prescribing 
the tincture in combination 
with bromide of potassium. 
Although later experience has 
not confirmed the pretensions 
of those who formerly vaunted 
Indian hemp as a cure for hy- 
drophobia, chorea, tetanus, 
and allied nervous ailments, 
we may sometimes produce 
good results in neuralgia and 
migraine by its cautious use. 



CANTHARIDES. 181 



ous excitement which we have 
just described. 

3. Digestive System No 

special effect seems to be pro- 
duced on the stomach or in- 
testinal canal, and the absence 
of constipation following its 
use gives Indian hemp one 
advantage over opium. 



Dose and Mode of Administration. 



B- 



Misce, fiat mistura. Capiat nnciam unam quarta quaque 
liora. 



Tincturse cannabis Indicae 


f*j; 


or 


4 


Gm. 


Mucilaginis acacise 


m ; 


i t 


32 


a 


Syrupi zingiberis 


f§ss ; 


a 


16 


( t 


Aqnse menthse piperita? 


f 3 v J; 


a 


1921 


a 



In neuralgia, etc. 



CANTHARIS— CANTHARIDES. 

[Cantharis vesicatoria, Lytta vesicatoria (Fabricius) , U. S. 

Officinal Preparations, U. S. 

Tinctura Cantharidis. Dose, iq;iij-v (.20 to .30 
Gm.). 

Ceratum Cantharidis. (For spreading blisters.) 
Ceratum Extraeti Cantharidis. 
Charta Cantharidis. (Blistering paper.) 
Collodium cum Cantharide. 
Linimentum Cantharidis. 
Emplastrum Pieis cum Cantharide. 
Unguentum Cantharidis (3ij in §j). 

Poisoning. 

Cantharides is an acrid and corroding animal poison. Its 
prominent symptoms are a burning sensation in the throat ; 
violent pain in the stomach and bowels ; nausea, vomiting, 
and purging — the dejections being frequently bloody and puru- 
lent ; great heat and irritation of the urinary organs, some- 
times the most painful priapism ; pulse quick and hard ; and 
convulsions, tetanus, delirium, and syncope. 

The morbid appearances are principally inflammation and 
16 



182 



CANTHARIDES. 



erosion of the stomach. If in substance, fragments of the 
flies, with their characteristic green, shining appearance, 
will be found adhering to the mucous coat, or mixed with 
the contents of the stomach ; there are also marks of inflam- 
mation in the intestines and urinary organs, but these are 
most evident when death does not soon follow the ingestion 
of the poison. 

Treatment — The promotion of vomiting by means of 
warm demulcents ; copious dilution, bleeding, the warm bath, 
opiate frictions, enemata of mutton broth, laudanum, etc. 
Camphor, though not an antidote, alleviates some of the 
most distressing symptoms. 

Antidote. 
There is no antidote for cantharides.] 

External Actions. 



Physiological. 

The first effect of the ap- 
plication of cantharides to the 
skin is tingling and smarting, 
speedily followed by vivid 
redness and severe burning 
pain. To this succeeds the 
formation of large blebs con- 
taining a watery fluid rich in 
albumen and fibrine ; and if 
the blister be allowed to re- 
main for any lengthened pe- 
riod in contact with the skin, 
ulceration and sloughing may 
supervene. It has been found 
that the moderate counter- 
irritant action of cantharides 
causes the copious exudation 
of white blood-corpuscles into 
the subcutaneous areolar tis- 
sue, with engorgement of the 
more superficial structures 
under! ving the skin, whilst 
the deeper strata look pale, 



Therapeutical. 

Blisters are used to fulfil 
the following indications : — 

1. To relieve pain. There 
can be no doubt that blisters 
frequently check pain most 
effectually, as in subacute 
pleurisy, pleurodynia, gas- 
tralgia, sciatica, and neural- 
gia, it being important that 
in this last-named affection 
the counter-irritant should be 
placed as near as possible to 
the root of the affected nerve. 

2. To check inflammatory 
conditions. There is no doubt 
that some local inflammations 
may be checked by blistering 
a neighboring vascular area. 
Thus, in iritis and some other 
inflammatory affections of the 
eye, benefit may be procured 
in this way ; and in acute 
rheumatism blisters applied 



CANTHARIDES. 



183 



annemic, and flabby ; the lungs 
even being affected in this 
way. It has also been shown 
that the irritant action of can- 
tharides may penetrate 
through the skin, and cause 
redness and inflammation of 
the pleura and peritoneum. 
The first constitutional effect 
of a blister is a slight eleva- 
tion and subsequent depres- 
sion of the temperature, with 
weakening of the action of 
the heart. 

It not uncommonly hap- 
pens that cantharides may be 
absorbed through the skin, 
and cause kidney irritation. 



immediately above the in- 
flamed joints rapidly remove 
pain and swelling. 

On this principle, also, Mr. 
F. Jordan recommends his 
iodine treatment of localized 
surgical affections already re- 
ferred to. 

In how far inflammations 
of internal organs may thus 
be treated with advantage is 
a somewhat open question ; 
for although the withdrawal 
of blood from the deeper 
structures might theoretically 
be considered beneficial, it is 
practically found that the 
pain and annoyance of blis- 
ters add to the feverish dis- 
comfort of the victims of 
acute disorders. 

3. To promote absorption. 
Blisters are supposed to aid 
the absorption of effused pro- 
ducts, fluid or solid, and are 
therefore much used in tho- 
racic dropsy, either pleural 
or pericardial, the latter 
stages of pneumonia, chronic 
joint-disease, etc. 

4. To stimulate and alter 
vascular or nervous functions, 
etc. Blisters may be employed 
to rouse patients from the stu- 
por of typhus, or narcotic 
poisoning, or various brain 
affections, to check obstinate 
vomiting, and under various 
other conditions laid down in 
works on practical medicine. 



184 



CANTHARIDES. 



Internal Actions. 



Physiological. 

Cantharides is a gastro- 
intestinal irritant, and also a 
renal stimulant and diuretic, 
causing an increased flow of 
urine, but frequently giving 
rise to a good deal of stran- 
gury, with painful, frequent, 
and difficult micturition, and 
bloody urine. This irritation 
may spread by sympathy to 
other allied organs, and uter- 
ine excitement on the one 
side, or excess of venereal 
appetite with chordee and 
seminal emissions on the 
other, may follow the admin- 
istration of large doses. 1 



Therapeutical. 

Cantharides is not much 
used internally, on account of 
its irritating properties. It 
is, however, occasionally pre- 
scribed in pyelitis and some 
chronic affections of the kid- 
ney, and in chronic diseases 
of the spine. 

Some authorities also have 
praised it highly in psoriasis. 
It has also been used for the 
purpose of procuring abortion, 
and it possesses emmenagogue 
properties. 



Cautions. Mode Of Administration. 

We must use blisters with caution under the following 
circumstances : — 

In the aged, infirm, or very young, where troublesome 
ulcei-ation is apt to ensue. 

In acute inflammatory conditions, and more especially 
those of the kidney. 

To cicatricial tissue, or to parts deprived of some of their 
vitality by the withdrawal of nervous influence, as in para- 
plegia. 

Blisters are usually kept on from ten to twenty hours, but 
we may well limit the period to six or eight hours, and de- 
velop the blebs by a subsequent poultice. When the desired 
effect has been produced, let out the watery fluid, and apply 
a thick layer of cotton-wool. 

1 [The tincture of cantharides, U. S. P., is more than twice the 
strength of the English preparation.] 



CAPSICUM — CARBON. 185 

CAPSICUM— CAPSICUM. 

\_Syn. Cayenne and African Pepper. 

The fruit of Capsicum annuum, Capsicum fastigiatum (Blum), 
and other species of Capsicum, U. S. 

Officinal Preparations, U. S. 

Infusum Capsici. Dose, f gss (16. Gra.). 
Oleo-Resina Capsiei. Dose, gtt. j (.06 Gm.). 
Tinetura Capsici. Dose, f 3j-ij (4. to 8. Gm.).] 

This is a topical stimulant to the mucous membranes, ex- 
citing the appetite in small doses, but in larger quantities 
causing gastro-enteritis. In some forms of sore throat, as in 
the early stage of tonsillitis, or in simple relaxation of the 
mucous membrane, it forms a useful addition to a gargle as 
infusum capsici. 

Recently it has been highly praised by Dr. Lyons, of 
Dublin, in ten-minim doses of the tincture before meals, for 
the relief of the nausea, depression, and drink-craving of 
the confirmed dipsomaniac. 



M. 



CARBO— CARBON. 

[Carbo Animalis — Charcoal prepared from bone, U. S. 

Used in preparing Cinchoniae Sulphas, Morphia, Quiniaa 
Sulphas, and Santoninum. 

Carbo Ligni — Charcoal prepared from wood, U. S. 
Used in preparing Acidum Sulphurosum and Potassii 
Iodidum. 

Officinal Preparation. 

Carbo Animalis Purificatus. 

Used in making Acidum Gallicum, Digitalinum, Strych- 
nia, and Veratria.] 

16* 



R. Tincturae capsici 


nx; 


or 




60 "Gm 


Tincture nucis vomicse 


"lx ; 


i i 




60 " 


Aoidi nitrici diluti 


TTlxx; 


<. ( 


1 


30 " 


Aquae ad f fj ; 


a 


32 


a 


Fiat haustus ter die sumendus. 








iful in drink-craving. 











186 



CARBON. 



Local Actions. 



Physiological. 

Charcoal has no purely 
local action on any tissue 
with which it is brought in 
contact, and as it is quite in- 
soluble it can exert no gene- 
ral influence on the functions 
of the body. It is therefore 
simply a mechanical agent 
and acts in virtue of the fol- 
lowing properties : — 

1. It not only freely ab- 
sorbs gases within its pores, 
but oxidizes and destroys 
those of an offensive and in- 
jurious nature, as sulphuretted 
hydrogen ; and further, it 
also deodorizes, by oxidation, 
and destroys organic impuri- 
ties of all kinds, thus decolor- 
izing solutions which contain 
them. 



Therapeutical. 

1. In virtue of its absorb- 
ing powers, charcoal is used 
in many of those cases of dys- 
pepsia where large quantities 
of gas are formed by prema- 
ture decomposition of the 
food, and where much pain, 
nausea, and want of appetite 
are experienced by the pa- 
tient. In consumption and 
many chronic stomach dis- 
orders charcoal acts well by 
relieving the flatulence which 
is often the chief discomfort 
of the sufferer. Charcoal is 
also an excellent deodorizer 
and antiseptic, and is used 
for these purposes in the con- 
struction of filters, contact for 
four months being sufficient 
to purify the foulest and most 
deeply stained waters ; and if 
the organic matter present 
does not exceed from 1 to 2 
grains per gallon the charcoal 
will permanently retain its 
cleansing properties. It may 
also be of great service in ab- 
sorbing and destroying offen- 
sive effluvia in the neighbor- 
hood of sewers or drains, and 
it used to be a fashionable ap- 
plication to unhealthy ulcers ; 
but cleaner and equally effec- 
tual antiseptics have now en- 
tirely displaced it from popu- 
lar favor. 

It is also occasionally em- 
ployed in the formation of 



CARDAMOM. 187 

respirators and as an adjunct 
to tooth powders, and Dr. 
Thorowgood advises its pre- 
scription in teaspoonful doses 
in bleeding piles. 
2. Animal charcoal pos- 2. If we are called very 
sesses the power of render- early to a case of poisoning 
ing various vegetable poisons by opium, aconite, strychnia, 
inert by placing them in a or other vegetable poison, we 
form of combination beyond may hope to do some good by 
the absorptive powers of the charcoal, provided that ab- 
stomach. sorption of the poisonous 

agent has not yet taken place 
to any extent. 

Mode of Administration. 

As a medicinal agent vegetable charcoal alone is used, 
and may be given in doses of from a tea- to a table-spoonful, 
great care being taken to insure perfect freshness, as its ab- 
sorptive powers are seriously impaired by keeping. It may 
be combined effectively with bismuth, or given in sandwich 
form between bread and butter, or moistened with spirit in 
a wineglass before suspension by water ; but in any case its 
unsightly appearance, gritty consistence, and insolubility in- 
terfere with its prescription in elegant form, and we may 
advise our patients with advantage to make use of Bragg's 
biscuits or Belloc's lozenges. 

As an antidote, animal charcoal must be given in con- 
siderable doses, as it is calculated that half an ounce is 
required to neutralize one grain of vegetable alkaloid. 
As an antiseptic it may be placed in shallow pans close to 
the outlet of drain or sewer ventilating shaft. 



CARD AMOMUM— CARDAMOM. 

[ The fruit of Elettaria Cardamomum, U.S. 

Officinal Preparations, U. S. 

Extraetum Coloeynthidis Compositum. Dose, 
gr. v-xxx (.30 to 2. Gm.). 

Pulvis Aromatieus. Dose, gr. x-xxx (.60 to 2. 
Gm.). 



188 CARAWAY — CLOVES. 

Tinetura. Cardamomi. Dose, f3j-ij (4. to 8. Gm.). 

Tinetura Cardamomi Composita. Dose, f^j-iv 
(4. to 16. Gm.). 

Tinetura Gentianae Composita. Dose, f5j-ij (4. 
to 8. Gm.). 

Tinetura Rhei. Dose, f3j-iv (4. to 16. Gm.). 

Vinum Aloes. Dose, f3j-f Jj (4. to 32. Gm.).] 

This is an agreeable stimulant and flavoring adjunct. 



[CARUM— CARAWAY. 

The fruit of Carum Carui, U. S. 
Officinal Preparations, U. S. 

Oleum Cari. Dose, gtt. j-x (.06 to .60 Gm.). 
Tinetura Cardamomi Composita. Dose, f£j- 
f£ss (4. to 16. Gm.). 

Caraway is an agreeable aromatic, used as a stomachic, 
or to prevent the griping of other medicines. The oil is 
most frequently employed, but an infusion may be made 
containing 5ij to Oj.] 



CARYOPHYLLUS— CLOVES. 

[ The unexpended flowers of Caryophyllus Aromaticus, U. S. 

Officinal Preparations, U. S. 

Infusum Caryophylli (Jij to Oj.). As a vehicle. 
Oleum Caryophilli. Dose, gtt. ij-vj (.12 to .40 Gm.). 

Cloves also enter into Spiritus Lavandula? Compositus, 
Syrupus Rhei Aromaticus, and Vinum Opii. 

Cloves are a stimulating stomachic, and may be given in 
substance in doses of gr. v-x.] Cloves, pimento, and oil of 
cajuput are carminative and perhaps antispasmodic, and may 
be useful in flatulent colic, hysteria, etc., more especially as 
adjuncts to other remedies. 



CASCARILLA — CASTOR. 189 

CASCARILLA—CASCARILLA. 

[The bark of Croton Eluteria, U. S. 

Officinal Preparations, U. S. 
Infusum Casearillae. Dose, a wineglassful.] 
Cascarilla is a li^ht and agreeable tonic. 



[CASSIA FISTULA—PURGING CASSIA. 

The fruit of Cassia Fistula, U. S. 

Cassia pulp is laxative in doses of one or two drachms, 
but is rarely used except in the officinal combination, Con- 
fectio Sennae, which is a favorite remedy against constipation 
in pregnancy. Dose, 3j-\j (^- to 8. Gm.).] 



[CASSIA MARILANDIC A — AMERICAN SENNA. 

The leaflets of Cassia Marilandica, U. S. 

This is a competent substitute for the imported senna as 
a cathartic, but must be administered in rather larger doses. 
It is much used in the form of infusion, combined with fen- 
nel, or some other aromatic, to prevent griping.] 



CASTOREUM— CASTOR. 

[A peculiar concrete substance obtained from Castor Fiber, U. S. 

Officinal Preparation, U. S. 

Tinctura Castorei. Dose, f3ss-ij (2. to 8. Gm.).] 

Castoreum and musk possess much the same properties, 
the only difference being in the greater strength of the 
latter. They are stimulant and antispasmodic ; but cas- 
toreum is rarely if ever used, and even musk, which was 
formerly much valued in France, and by Graves of Dublin, 
in typhus, pneumonia, and other diseases tending to assume 
an adynamic type, has now also fallen into comparative 
disuse. 






190 



CATNEP — CATECHU. 



[CATARIA— CATNEP. 

The leaves and tops of Nepeta Cataria, U. S. 

Infusion of catnep (catnep tea) is a favorite remedy for 
flatulent colic in infants, but is rarely used for any other 
purpose in regular practice, although a hot infusion is a 
domestic remedy for amenorrhea and hysteria.'] 

CATECHU—CATECHU. 

[An extract prepared principally from the wood of Acacia Catechu, U. S. 
Officinal Preparations, U. S. 

Infusum Catechu Compositum. Dose, fjj-iij 
(32. to 96. Gm.). 

Tinetura Catechu. Dose, f3j-iij (4. to 12. Gm.).] 

Internal Effects. 

Physiological. Therapeutical. 

It is a much-used drug in 
the relaxed conditions of 
various mucous membranes, 
but more especially in diar- 
rhea, and it constitutes an 
essential ingredient in the 
mixtures generally prescribed 
for the relief of that condi- 
tion. 



Catechu has powerful as- 
tringent properties. 



or 



R,. Tincturse catechu 

Pulveris cretae aromatici [Br.] 

Tincturse opii 

Mucilaginis acacise 

Aquse ciimamomi 
Misce, fiat mistura, cujus sumat semunciam post singulas de- 
jectiones liquidas. 



f^j ; 
sy ; 
f£ij ; 

ad f.^vj ; 



24 



8 
32 

192 



Gm. 



[Cerata. 

List of Cerates officinal in the -U. S. Pharmacopoeia : 

Ceratuui (formerly Ceratum adi- Ceratum Resinse. 
pis) 



Ceratum Cantharidis. 
" Cetacei. 
" Extracti Cantharidis. 
" Plumhi Subacetatis. 



Resinse Compositum. 

Sabinse. 

Saponis. 

Zinci Carbonatis.] 



WAX — SPERMACETI. 191 



CERUM— WAX. 

[Cera Alba. Yellow wax bleached, U. S. 
Cera Flava. A peculiar concrete substance prepared 
by Apis mellifica, U. S. 

Wax is a good excipient, and is the basis of the cerates. 
It also enters into pills, ointments, plasters, and suppositories. 
It was an ancient remedy for dysentery.~\ 



CERIUM—CERIUM. 

[Cerii Oxalas— Oxalate of Cerium. Dose, gr. j-v 
(.06 to .30 Gm.).] 

The oxalate of cerium, in doses of from gr. j to gr. ij, is 
a popular remedy in the vomiting of pregnancy, its mode of 
action being quite unexplained, and its success being, accord- 
ing to my own experience, greatly exaggerated. 

It is generally prescribed in the form of pill. 

]£. Cerii oxalatis gr. xxiv ; or 1|50 Gm. 

Extracti gentianse gr. xxxvj ; " 2|40 " 

Misce, fiant pilulae duodecirn, quaruin capiat imam bis in 
die. 

[Disappointment from the use of this drug may be ex- 
plained by the fact that the commercial oxalate of cerium 
often contains salts of lanthanum, didymium, and other 
impurities. The chemically pure oxalate of cerium is pro- 
bably 'one of the most efficient remedies against the vomiting 
of pregnancy that we possess ; given in powder, in pill, or 
suspended in mucilage.] Another reason for disappointment 
probably is that the usually prescribed dose is much too 
small. Some good authorities advise us to give ten grains 
every four hours, one dose being invariably taken before the 
patient rises from bed. 



CETACEUM—SPERMACETI. 

\_A peculiar concrete substance obtained from Physeter macrocephcdus, 

U. S. 

Officinal Preparations, U. S. 

Ceratum Cetacei, Charta Cantharidis, Unguentum Aquae 
Rosae.] 



192 ICELAND MOSS — PIPSISSEWA. 

Requires no special notice. [Its internal use has been 
generally abandoned. The cerate, a perfectly bland prepa- 
ration, may be used as a dressing to blistered surfaces. The 
unguentum aquae rosa?, or cold cream as it is called, is much 
used for chapped hands and lips, and excoriated places.] 



OETRARIA— ICELAND MOSS. 

[Cetraria Island ica (A charms, Lichen Univ.), U. S. 

Officinal Preparations, U. S. 

Decoctum Cetrariae. Dose,f|ss~ij (16. to 64. Gm.).] 

This plant is supposed to have nutritious properties [and 
formerly enjoyed a great reputation as a demulcent and tonic 
in 'pulmonary affections'^. 

[Chartae. 

The officinal papers are Charta Cantharidis and Charta 
Sinapis.] 



[CHENOPODIUM— WORMSEED. 

The fruit of Chenopodium Anthehninticnm, U. S. 
Dose, in substance, gr. xx-xl (1.30 to 2.60 Gm.). 

Officinal Preparation. 

Oleum Chenopodii. Dose for a child, git. v-x (.30 
to .60 Gm.). 

Internal Effects. 

A popular remedy against lumbricoid worms. It may be 
given night and morning for two or three days, then to be 
followed by a brisk cathartic] 



[CHIMAPHILA— PIPSISSEWA. 

The leaves of Chimaphila umbellata (Pursh, Flor. Amer. Sept.), U. S. 
Officinal Preparations, U. S. 

Decoctum Chimaphila^. Dose, ad libitum. 
Extra etum Chimaphilse Fluidum. Dose, n^ xx- 
xl (1.30 to 2.60 Gm.). 



CHIRETTA — CHLORAL. 



193 



Wintergreen is an Indian remedy for scrofula, rheuma- 
tism, and nephritic affections, and it enjoys some reputation 
as an alterative in regular practice, and has been recom- 
mended as a diuretic in dropsy. It is also tonic and astrin- 
gent.] 



[CHIRETTA— CHIRETTA. 

The herb and root of Agathotes Chirayta, U. S. 
Not much used in this country. See note under Gentian.] 



CHLORAL— CHLORAL. 

\_Syn. Hydrate of Chloral, U. S. 
Treatment of Poisoning. 

Strychnia is the physiological antidote for chloral ; and 
the treatment must be conducted on general principles for 
narcotic poisoning, by evacuants, counter-irritants, stimu- 
lants, and maintaining bodily heat.] 

Local Actions. 



Physiological. 

When applied externally, 
chloral has been by some 
authorities supposed to have 
sedative properties, and it is 
also an undoubted antiseptic. 



It 



Therapeutical. 

It has been recommended 
as an external application in 
neuralgia, rheumatism, and 
other painful affections. 

Used as a dressing to ulcer- 
ated surfaces, it seems to act 
well by removing the fetor of 
discharges and lessening 
pain ; and it has been succes- 
fully employed, in solution, 
for the preservation of ana- 
tomical preparations, and for 
the injection of bodies, the 
only drawback to this being 
the disagreeable smell which 
results, and a certain amount 
of blackening of the tissues 
on exposure to the air. It is 
also used to check the irrita- 
tion of eczema and prurigo. 



194 



CHLORAL. 



Constitutional Actions. 



I. Nervous System 1. 

Brain Chloral [acts as a 

sedative to the nervous cen- 
tres and secondarily to the 
heart. In small doses it pro- 
bably] produces an anaemic 
condition of the brain, and 
thus causes sleep by imitat- 
ing the natural anatomical 
arrangement of that process. 
The resulting slumber begins 
very quickly after the dose 
is swallowed, it is usually 
sound and dreamless, and 
the patient wakes in seven 
or eight hours, well re- 
freshed, and without any 
marked feelings of malaise 
or digestive disturbance. 
Exceptions to this, however, 
have been observed, and in 
these chloral has caused pre- 
liminary excitement ; but it 
is more than probable that 
an explanation may be found 
in the use of the impure spe- 
cimens of the drug too often 
retailed. Liebreich believes 
that chloral exerts its hyp- 
notic influence by undergoing 
transformation in the blood 
into chloroformic and formic 
acid ; but this is improbable 
for the following reasons : — 

(1) The alkali of the blood 
is too feeble to liberate the 
chloroform, and the albumen 
is considered antagonistic to 
such a process. 

(2) No smell of chloroform 
can be observed in the breath, 



1. Chloral is an excellent 
hypnotic, causing sound and 
refreshing sleep, without the 
digestive disturbance which 
usually follows the use of 
opium. It may be given in 
simple insomnia from mental 
worry, overwork, or other 
causes, and it is a remedy of 
great value in all diseases in 
which dangerous depression 
is apt to follow the continu- 
ous want of sleep. Thus, in 
typhus, in delirium tremens, 
where it must be pushed bold- 
ly in conjunction with an ab- 
solute suspension of all alco- 
hol, in phthisis, acute mania, 
etc., we may prescribe it with 
much confidence of success. 
It has also been recommend- 
ed in France as an anaesthetic 
by [intravenous] injection ; 
from 2 to 4 grammes, thus 
made to enter the veins, be- 
ing there supposed to yield 
chloroform, which then ex- 
erts its usual influence. There 
is no reason, however, to be- 
lieve that anaesthesia thus pro- 
duced would be in any degree 
safer than the old mode of in- 
halation ; and as the patient 
is thus exposed to the addi- 
tional risks of thrombosis, in- 
flammation of the veins, and 
the entrance of air, one can- 
not wonder that this process 
has found no favor in this 
country. In addition to this, 
recent observation goes to 



CHLORAL. 



195 



and no anaesthetic effect is 
produced on the sleeper by 
moderate doses. 

2. Spinal Cord. — The re- 
flex irritability of the spinal 
cord is very decidedly less- 
ened, and the respiratory cen- 
tre becomes weakened, and 
eventually paralyzed. 



3. Sympathetic and General 
Nervous System The vaso- 
motor system is enfeebled, 
but no special effect seems to 
be produced on other nervous 
structures, unless we believe 
a part of the loss of muscular 
power, sometimes observed in 
those who have taken chloral 
for some time, to be due to an 
action on the motor nerves. 

II. Circulatory System 

Chloral has a powerful action 
on the heart, lowering and 
weakening its action by para- 
lyzing its contained sympa- 
thetic ganglia. That this ef- 
fect is not produced through 
the medium of the vagi is 
shown by the fact that it 
comes on even after these 
nerves are cut, and the ter- 
minal cardiac filaments para- 



show that it is in no sense a 
true anaesthetic. 

2. Chloral is of service in 
some spasmodic diseases, as 
chorea,whooping-couyh, asth- 
ma, incontinence of urine, 
labor after-pains, etc. It is 
also undoubtedly useful in 
[trismus nascentium, puer- 
peral convulsions, and] cases 
of tetanus, many of which 
have recovered during its ad- 
ministration ; Gubler record- 
ing 36, with the proportion 
of 21 recoveries, whilst Cho- 
part has collected from all 
sources, 80 successful cases. 
It may also be given as an 
antidote to strychnia. 

3. Chloral, having no in- 
fluence over sensory nerves, 
has no power, per se, of allay - 
iny pain, and is, therefore, 
useless in that class of cases 
where opium is of such signal 
service. It seems, however, 
to relieve the pain of labor, 
without causing inertia of 
uterus, or doing harm to mo- 
ther or child. 

II. Chloral, weakening 
cardiac action, must not be 
given where we have any rea- 
son to suspect an enfeebled 
state of the heart muscle. 
This shows how useless chlo- 
ral is likely to be as a narco- 
tic, when flaccid vessels allow 
free gravitation of blood to 
the brain during the recum- 
bent posture, thus congest- 
ing its tissues, and effectually 



196 



CHLORAL. 



lyzed by atropine. Along 
with this slowing of the pulse 
we get lessened arterial ten- 
sion from dilatation of the 
superficial vessels. [Profes- 
sor Wood 1 considers it most 
probable that the chloral in- 
fluences the heart through the 
centres at the base of the 
brain.] 

III. Respiration and Tem- 
perature The breathing 

tends to become slower, and 
finally to cease, from paraly- 
sis of the respiratory centre ; 
but urgent dyspnoea has occa- 
sionally been observed, and 
this has been ascribed to dila- 
tation of the pulmonary ves- 
sels, causing an increased af- 
flux of blood to be directed 
suddenly to the lungs. 

The temperatare falls, and 
this is no doubt due to sur- 
face evaporation produced by 
the dilated cutaneous vessels. 

IV. Secreting and Diges- 
tive Systems — No special in- 
fluence is produced on any of 
these, but occasionally vomit- 
ing and purging have followed 
the use of chloral. 



preventing sleep. Its action 
is most manifest when the 
circulation is strong and the 
arteries tight. 



III. This effect on the re- 
spiratory centre naturally sug- 
gests caution in prescribing 
chloral in cases of advanced 
bronchitis with rapidly accu- 
mulating mucus secretion and 
deficient oxygenation of the 
blood. It has been much 
used in whooping-cough, but 
I have been unable to trace 
any special therapeutic effect 
beyond the soothing of the 
cough at night by producing 
sleep. 

Chloral has been recom- 
mended as a good remedy in 
sea-sickness. 



Absorption and Mode of Elimination. 

Chloral is rapidly absorbed by the blood, and given out 
probably by the urine, the breath, and perhaps the skin. 

Poisonous Effects. Antidotes. 

Chloral may kill by car- Here our efforts must first 
diac syncope, and, as this ef- be directed to obviating the 

1 [Therapeutics and Materia Medica, 2d ed., Pliilada. 1877, p. 
321.] 



CHLORAL. 197 

feet has been known to follow tendency to death. We must 
a single dose of 30 grains, endeavor to restore the heart's 
considerable caution must be action by warmth, stimulants, 
exercised in its use ; or again, strong coffee, and promote 
death may ensue from paraly- breathing by irritation of the 
sis of the respiratory centre, surface, galvanism, and arti- 
with coma and gradual suffo- ficial respiration ; counteract 
cation ; and, finally, a series the rapidly-lowering tempe- 
of cases has been recorded in rature, on which so much 
which symptoms arose akin danger depends, by warmth ; 
to blood poisoning, with pur- and finally employ physiolo- 
puric and scorbutic eruptions, gical antidotes, such as atro- 
ulceration of gums, and great pia and strychnia. One case 
prostration, ending in death. is recorded in which alarming 

symptoms, caused by taking 
370 grains, were removed by 
two subcutaneous injections 
of strychnia. 

Cautions, Mode of Administration, Dose, etc. 

[It is recommended that re-crystallized chloral should only 
be prescribed, as the commercial article is liable to be con- 
taminated with impurities, and the results of decomposition.] 
Liebreich holds that many of the commonly described bad 
effects of chloral are due to impure preparations, which are 
unfortunately only too effectually masked by the syrups now 
in such general use. It is easy to detect impurity of the 
crystals, which should not be acicular in form, and cake 
chloral should always be distrusted. 

The use of chloral requires caution, as many instances of 
death from its employment are on record, and other cases 
have been noted in which very serious symptoms followed 
doses varying from 30 to 50 grains. We must also be mind- 
ful of other physiological peculiarities. Thus great muscular 
prostration, more especially affecting the legs, and causing 
staggering, not very unfrequently follows its continued use. 

Persons vary, however, in a very remarkable manner with 
regard to their susceptibility to the action of chloral, alcohol- 
ism lessening this in marked degree. Mr. Hulke {Clin. Soc. 
Trans. 1875) records a case in which a young lady, set. 23, 
took in one dose 320 grains, causing lividity, failure of re- 
spiration, weakened action of the heart, and contraction of 

IT* 



198 CHLORAL. 

the pupils, from which she was recovered with difficulty by 
the stomach-pump, artificial respiration, and strong coffee. 
Mr. Bishop, of Boston, had a case in which a patient, suf- 
fering from delirium tremens, took 165 grains, followed by 
thirty-six hours' profound sleep, and a perfect cure on waking. 

Prof. Gairdner met with a case of chorea in a little girl 
of eight, where 45 grains were taken by mistake with perilous 
immediate consequences, but entire removal of the disease. 
It is believed on somewhat vague evidence, that chloral-eating 
is practised on a large scale with resulting cerebral anaemia, 
and moral and muscular weakness ; and the best-marked case 
I have met with is published by Mr. Tuflis, of the Edinburgh 
Asylum {Edin. Med. Journ. 1877), where 180 grains were 
regularly taken every day in frequent doses, causing dys- 
pepsia, moral perversion, muscular weakness, a feeble heart, 
loss of memory, and epileptiform fits, speedily removed by 
withdrawal of the drug. 

Various skin eruptions, usually confined to the face, begin- 
ning as spots of roseola, coalescing to form patches of ery- 
thema, occasionally generally diffused purpuric patches, and 
the very peculiar deep flushing of the face following the use 
of stimulants, and due no doubt to vaso-motor paralysis, have 
been carefully described by Dr. Crichton Browne and other 
observers. 

There seems no doubt that chloral acts more powerfully in 
persons w r hose blood is strongly alkaline, and Prof. Konig 
found that the previous administration of sodium bicarbonate 
heightens the narcotic, effect. In this way is explained the 
great susceptibility to the action of chloral noted by Dr. 
Russel, of Glasgow, in typhus fever. Liebreich believes it 
to act unfavorably in acute rheumatism, on account of the 
acid state of the blood. He recommends us never to give it 
on an empty stomach, nor to combine it with milk. 

Considering the undoubted fact that not only dangerous 
symptoms,, but even death, have followed a dose of 30 grains 
[and even of 10 grains], we must begin, as a rule, with 20 
grains [or a smaller quantity], to be repeated as occasion 
requires. We must remember, however, that the narcotic 
action of chloral is not invariably exhausted in the single 
sleep to which it originally gives rise, but it may be held 
over until next night, so that our best practice w 7 ill be to give 
a full dose only once in the forty-eight hours. The taste and 
smell of chloral being pungent and disagreeable, we must 



CROTON-CHLORAL. 199 

endeavor to render our prescription as palatable as we can. 
The syrup contains 10 grains to the drachm. Or we may 
use the folio win 2: formula : — 



I£. Chloral, hydratis gr. xx ; or 1 

Syrupi aurantii f5j ; "4 

Aq. nienth. pip. ad f §ij ; " 64 

Fiat haustus hora somni sumendus. 



30 Gm. 
a 

" M. 



[The addition of gr. v of chloral to a small dose of morphia 
greatly adds to its hypnotic effect, and prevents unpleasant 
results that sometimes are produced by morphia alone.] As 
a preservative fluid for anatomical purposes we may use gr. v 
ad 3j ; as a dressing for wounds, ulcers, and sore nipples, etc., 
gr. xv ad 3J ; in eczema, gr. xxx to lx to an ounce of lard. 

[Note. — Chloral- Camphor. By rubbing together gurn camphor 
and chloral, a fluid is produced resembling simple syrup. This has 
been recommended as a local anaesthetic in neuralgia, applied with 
a brush to the external skin. It is rubefacient, but not vesicating.] 
By the addition of this to unguentum an application may be con- 
veniently and very efficiently made to prurigo (Bnlkeley). 



Crot on- Chloral — Butyl Chloral Hydrate. 

(Not Officinal.) 

\_AJhydrate of trichlorbutylaldehyd made by the action of chlorine upon 
acetic aldehyde and distillation.] 

The name of Butyl Chloral, advised by Liebreich, would 
be an improvement, as preventing the idea of any relation- 
ship to croton oil. Dose, gr. iij to x (.20 to .60 Gm.). 

Local Action. 
None has been described. 

Constitutional Action. 

Physiological. Therapeutical. 

I. Nervous System. — 1. 1. Croton-chloral has been 

Brain. — Croton-chloral highly praised by its disco- 
causes sleep in from fifteen to verer, Liebreich, as a nar- 
twenty minutes. cotic, being given by him in 

doses of from 15 to 30 grains 
(1. to 2. Gm.). There is 
little English experience to 



200 



CRO TON- CHLORAL. 



2. Spinal Cord No ac- 
tion is produced on the spinal 
cord, nor consequent muscu- 
lar relaxation. Some para- 
lyzing influence is eventually 
excited on the medulla. 

3. Sympathetic and other 
Nervous Sy sterns No influ- 
ence seems to be exerted on 
the vaso-motor nerves, but on 
the fifth a well-marked seda- 
tive effect is noted, indicated 
by anaesthesia of the head and 
face, loss of irritability of the 
eyeball, and failure of the 
nerve-trunk itself to respond 
to galvanic stimulation. 



quote on this heading, as the 
doses used here are far too 
small to produce sleep ; but 
as the drug has no depressing 
action on the heart like chlo- 
ral, there is no doubt that we 
may prescribe it with com- 
parative freedom. [Subse- 
quent experience has shown 
that in some patients danger- 
ous and even fatal symptoms 
have been produced by ordi- 
nary doses in cases of organic 
heart disease. It appears to 
resemble chloroform in its un- 
certainty and danger.] 



II. Circulation — Croton- 
chloral has no tendency tp 



3. The anaesthetic influ- 
ence of croton -chloral would 
naturally suggest its use in 
facial neuralgia, and a good 
deal of success has been thus 
obtained in dealing with this 
troublesome affection, doses 
of from 2 to 6 grains having 
generally been prescribed. 
Liebreich has so much faith 
in this sedative action, as to 
advise its use as an anaesthetic 
in operations about the face. 
[Before administering this 
remedy the heart should al- 
ways be examined, as croton- 
chloral is contra-indicated by 
cardiac disorder.] 



CHLORINE. 

a 



201 



weaken or lower the action 
of the heart [in health]. 

III. Respiration and Tem- 
perature. — Croton- chloral 
tends to lower the rate of 
breathing, and eventually 
kills by paralyzing the respi- 
ratory centre. (It is better to 
dissolve croton -chloral in gly- 
cerine and water, than in al- 
cohol.) 



[III. Croton -chloral close- 
ly resembles chloral hydrate 
in its action upon the system, 
except in possessing greater 
danger. For this cause its 
use has been almost entirely 
discontinued in this country.] 



CHLORINUM— CHLORINE. 

[Aqua Chlorini, IT. S. Chlorine-water. Dose, largely 
diluted, fjj-iv (4. to 16. Gm.).] 

The use of chlorine is almost entirely confined to its ex- 
ternal application. 



Physiological Action. 

1. Concentrated chlorine 
gas directed upon the skin 
causes redness and smarting, 
followed by a pustular erup- 
tion and even erysipelatous 
inflammation. 

2. It is an excellent disin- 
fectant, decomposing sulphu- 
retted hydrogen and ammo- 
nium sulphide at once and 
more effectually than any 
other gas, and also destroys 
organic matter in the air, as 
it bleaches organic pigments 
and destroys odors, either by 
abstracting hydrogen or by 
oxidizing (Parkes). 

3. The inhalation of chlo- 
rine gas is stimulating or irri- 
tating to the lungs. 



Therapeutical Action. 

1. It is never, however, 
used as a counter-irritant. 



2. It is therefore exten- 
sively used as given off by 
chloride of lime to purify the 
air from offensive effluvia, 
and to destroy infectious 
germs. In the form of lotion 
it is also used to cleanse foul 
or sloughing sores. 



3. It has therefore been 
used in some forms of chronic 
bronchitis and phthisis, but 
is not now much employed. 
[It may be used in strychnia- 
poisoning.^ 



202 CHLOROFORM. 

Internal Use. 

Chlorine used to be given internally in medicine in various 
infectious fevers with a view to disinfection, but this has now 
become quite obsolete. [As extemporaneously made by the 
action of muriatic acid 3j> upon chlorate of potassium gr. x, 
to which a pint of water is added in successive portions, it 
is recommended by Watson for diphtheria and other zymotic 
diseases.] 

Dose and Mode of Administration. 

As a disinfectant it may be obtained by acting on chloride 
of lime with water or dilute sulphuric acid, or by pouring 
four parts by weight of strong hydrochloric acid on one part 
of powdered binoxide of manganese, or mixing four parts of 
common salt and one of binoxide of manganese with two 
parts by weight of sulphuric acid and two of water, varying 
the quantities according to the size of the room. 

Vapor chlori [Br.] is used for inhalation, and liquor chlori 
[Br.] may be employed diluted as a lotion, or given inter- 
nally. 

Disadvantage. 

The great drawback of chlorine is the very irritating 
nature of its vapor, rendering it unsuitable for general use in 
rooms actually inhabited by the sick. 



CHLOROFORMUM— CHLOROFORM. 

[Chloroformum Venale, U. S. Commercial Chlo- 
roform. 

Chloroformum Purifieatum, U.S. Purified Chlo- 
roform. 

Officinal Preparations, IT. S. 

Mistura Chloroformi (chloroform f|ss, camphor gr. 
lx, velk of one egg, and alcohol fo v J)« Dose, fjss (16. 
Gin.).- 

Spiritus Chloroformi (fgj to alcohol fgvj, IT. S.). 1 
Dose, f'3ss-j (2. to 4. Gm.). 

1 [Spiritus Chloroformi, Br., contains one part in twenty.] 



CHLOROFORM. 203 

Linime ntum Chloroformi (f chloroform, | olive 

oil). 

It is used in the manufacture of Liquor Gutta-Perchae, and 
in preparing Atropia. 

Poisoning. 

In the treatment of chloroform-narcosis, when there is 
failure of the circulation, vigorous and prompt measures are 
called for. The surface of the chest should be smartly slapped 
with the fringe of a towel dipped in ice-water, a piece of ice 
may be introduced into the rectum, the head must be lowered 
and the legs elevated, and ammonia held to the nose ; an 
assistant meanwhile practising artificial respiration. This 
treatment Prof. Gross has found to be invariably effective, 
and he has not lost a patient out of more than 5000 cases of 
chloroform -anaesthesia.] 

Local Action. 
Physiological. Therapeutical. 

Chloroform, when allowed The locally sedative action 

to remain for some time in of chloroform has led to its 

contact with the skin, acts as extensive use as an applica- 

an irritant, causing redness tion for the relief of rheu- 

and smarting, followed by matic or neuralgic pains, the 

vesication. liniment being a convenient 

It has also, however, some form, 

sedative properties. It is also a useful remedy 

Chloroform is an excellent for allaying the itching of 

solvent of caoutchouc, gutta some chronic forms of skin 

percha, and many fats and disease. 
resins, and it also greatly as- 
sists the cutaneous absorption 
of most of the alkaloids. 

Constitutional Action. 

Chloroform, when taken It is a useful remedy in 

internally, may act as a stim- hysteria, asthma, and nervous 

ulant, sedative, and anti- palpitation, for the arrest of 

spasmodic. There seems, sea-sickness and other forms 

occasionally, little doubt that of vomiting, and for the 






204 



CHLOROFORM. 



soothing and quieting of some 
forms of irritable cough. 



[when administered for its 
anaesthetic effects, under cer- 
tain circumstances,] it excites 
erotic sensations in women, 
and leads them to bring un- 
founded accusations against 
medical men. 



Combined Local and Constitutional Effect. 

Under this heading it may be convenient to discuss the 
anaesthetic properties of chloroform, and this we will now 
proceed to do on the plan adopted generally throughout these 
pages. 






Physiological. 

1. On Brain and Nervous 
System. — Chloroform has 
first a stimulating, and sec- 
ondly a sedative, action on 
the brain, a good deal of 
excitement and struggling 
taking place during the early 
stages of inhalation, whilst, 
during the later, narcosis is 
complete, and the patient 
lies quiet and motionless. 
This condition resembles 
natural sleep in being asso- 
ciated with anaemia of the 
brain, but differs by its ren- 
dering the patient quite in- 
sensible to external impres- 
sions, including the most 
severe cutting operations, 
this effect being due to a 
paralyzing influence of the 
drug on the ganglionic cen- 
tres of the sensory nerves. 

The reflex functions of the 
cord are also lulled to slum- 
ber, and, if the inhalation is 
pushed too far, paralysis of 



Therapeutical. 

1. In the early stage of 
inhalation the patient usually 
feels confused and giddy, 
his eyes are suffused, his face 
congested, and the heart 
beats rapidly. This is often 
followed by apparent insen- 
sibility, from which, how- 
ever, he can readily be 
roused* and very frequently 
a stage of violent excitement 
ensues, during which he 
struggles violently and with 
remarkable muscular force, 
talking and singing incohe- 
rently meanwhile. This 

stage has been compared with 
that of alcoholic intoxica- 
tion. Succeeding to this we 
have that of " anaesthesia,'' 
in which he is profoundly 
insensible, with contracted 
pupils ; and finally we reach 
that of "narcosis," in which 
the face becomes congested, 
the pupils dilate, and sterto- 
rous breathing sets in. Chlo- 



CHLOROFORM. 



205 



the respiratory centre may 
ensue. 

2. Heart and Circulation. 
— On the heart the influence 
of chloroform is at first 
slightly stimulating, the pulse 
becoming quickened ; but 
secondary depression follows 
from a paralyzing influence 
on the sympathetic ganglia, 
the pulse now growing 
slower, and the arterial ten- 
sion becoming lowered. 

3. Respiration and Tem- 
perature. — The respiration 
tends at first towards in- 
creased rapidity, but if the 
inhalation is pushed so far 
as to affect the respiratory 
centre, the breathing grows 
slower, and finally ceases. 
[It may cease suddenly with- 
out warning ; and there is no 
means of determining pre- 
viously, at least with our pre- 
sent knowledge, when this 
accident will occur, or what 
patients are particularly liable 
to it. This is the great ob- 
jection to chloroform.] We 
usually observe some tend- 
ency to perspiration attend- 
ing chloroform inhalation, 
and a consequent slight re- 
duction of temperature. 

4. On the digestive and 
secreting organs chloroform 
seems to exert no marked 
influence, the sickness so fre- 
quently observed during re- 
covery being purely reflex in 
character. 

18 



roform inhalation is [only] 
used during its first stage to 
alleviate the pain of child- 
birth, it being found that 
full anaesthesia under these 
circumstances is apt to relax 
the uterine muscular tissues, 
and not only to check their 
contraction, but to predis- 
pose to future hemorrhage. 

During the second stage 
chloroform is used for the 
purpose of obtaining full and 
complete insensibility to pain 
during the performance of 
operations ; and this invalu- 
able property has deprived 
the practice of surgery of 
much of its former horrors. 

We also employ it freely 
to relax muscular tension 
and spasm, and so facilitate 
the reduction of hernia and 
dislocation ; for diagnostic 
purposes, in order to dispel 
phantom uterine tumors, as 
well as to enable us to make 
a careful examination of ex- 
tremely painful parts. 

It is also of service for 
the relief of various forms 
of spasmodic affections, as 
whooping - cough, infantile 
and puerperal convulsions, 
chorea, and to alleviate pain, 
in cancer, during the passage 
of renal or biliary calculi, 
and under many other condi- 
tions. 



206 



CHLOROFORM. 



Poisonous Properties. 



Chloroform may kill in 
two ways. (1) By primarily 
paralyzing the heart, and this 
has generally been considered 
to be due to the inhalation 
of air too highly charged with 
chloroform vapor, Mr. Clo- 
ver holding that over 5 per 
cent, must be considered 
dangerous. Dr. Brunton, 
however, explains very inge- 
niously how it is that small 
doses are more apt to produce 
this effect than large, exciting 
as they do that irritative ac- 
tion of the terminal filaments 
of the 5th nerve, which are 
well known to cause stoppage 
of heart ; and thus shows us, 
what could hardly be under- 
stood before, why so consi- 
derable a proportion of chlo- 
roform deaths have occurred 
during the performance of 
very trivial operations, or 
where the vapor has been 
timidly given. 1 

It seems highly probable, 
however, that, in accordance 
with the views of Syme, Lis- 
ter, Chiene, etc., fatal acci- 
dents from chloroform are 
not so liable to proceed from 
the heart as (2) from the 
respiratory function ; and this 
mode of fatal accident has 
been again subdivided into 
two headings : 1st. Death by 
apnoea, or stoppage of the 



During chloroform-inhala- 
tion we must watch the pulse, 
and specially note enfeeble- 
ment, irregularity, or cessa- 
tion of its beats. Sudden 
pallor of the face, lividity, 
and gasping for breath are 
signs of ill omen. If the ac- 
tion of the heart seems to 
fail, we must administer 
stimulants by the mouth or 
rectum, and excite the cuta- 
neous surface. Galvanism 
seems more likely to exhaust 
than excite the contractility 
of the heart muscle ; and 
galvano-puncture, so much 
vaunted by foreign observers, 
has not been tried in this 
country. 



Chloroform accidents de- 
pending, in a great majority 
of cases, on failure of respi- 
ration, we must endeavor to 
re-excite this function by 
cold sprinkling, or ammonia 
vapor, but, most hopefully, by 
the steady and persevering 
use of artificial respiration. 
Always, however, see that 
no mechanical hindrance to 
breathing exists, and more 



1 [If this were true, there should be more deaths from heart-fail- 
ure under ether than chloroform, because ether is more irritating 
to the upper air passages than chloroform.] 



CHLOROFORM. 



201 



breathing from nervous in- 
fluence or mechanical causes ; 
and this may arise, either 
from the tongue falling back, 
or, 2dly, from closure of the 
glottis by paralysis of the in- 
trinsic muscles of the larynx. 
Of these, the first is by far the 
more common, and death is 
often caused by falling back of 
the tongue, closing the glottis. 

© 7 © © 

It therefore follows that, 
whilst engaged in the admin- 
istration of chloroform, the 
breathing must be very care- 
fully watched. [3. Death may 
also be produced by asphyxia, 
or] suffocation from excessive 
formation of carbonic acid in 
the blood. 



especially take care to draw 
the tongue well forward ; 
this little operation acting 
not only by removing its own 
mechanical impediment to 
breathing, but by drawing 
forward the epiglottis, pulls 
on the aryteno-epiglottidean 
muscles and opens the glottis. 
Mr. House, of Guy's Hospi- 
tal, has saved two cases of 
impending suffocation by tra- 
cheotomy. 

[It often answers the same 
purpose to raise the chin as 
far as possible from the 
sternum. 

Dr. Howard has recently, 
with good reason, advocated 
throwing the head backw T ards 
and downwards over the edge 
of a bed or couch, so that 
any fluid that might have en- 
tered the trachea would flow 
outwards. C] 

Galvanic stimulation of the 
phrenic nerve has been re- 
commended, and several ap- 
parently hopeless cases have 
been saved by the process of 
inversion as originally pro- 
posed by Nelaton. Nitrite 
of amyl has also been suc- 
cessfully used by inhalation. 



Absorption and Elimination. 

Chloroform is rapidly absorbed and rapidly given off by 
the breath and urine, in which secretion it can be readily 
detected. 

Mode of Administration. 

Fatal accidents from chloroform have become so alarm - 
inglyfrequent of late — the total number, according to Bartho- 



208 CHLOROFORM. 

low, amounting to 500 — that some surgeons even consider 
its use unjustifiable ; but it is on the whole by far the best 
anaesthetic, and, by adopting the following precautions, we 
may hope to imitate the success of the Edinburgh School, 
where danger or inconvenience rarely occurs, Mr. Syme 
having met with no death during 8000 administrations. 

1. Never permit inhalation to take place in a sitting pos- 
ture, and see that the patient's neck is free from all con- 
striction. 

2. Give strict orders that no solid meal be taken for at 
least two or three hours previously [solid food should not be 
eaten for at least twelve hours, as a safe precaution], but a 
little beef-tea may be allowed, and a small sip of brandy is 
useful just before the operation. The sickness which so fre- 
quently attends a loaded stomach is not only inconvenient, 
but lias proved fatal by suffocation from the drawing of 
vomited matters into the air- passages. And, in addition to 
this danger, vomiting is attended with special risks after 
such operations as ovariotomy and cataract extraction, and 
after the first of these it occasionally continues with exhaust- 
ing pertinacity. 

3. Use no special form of inhaler, but pour chloroform 
upon a towel or other porous material, and give it without 
fear, allowing free admixture of the vapor with sufficient 
atmospheric air. Tell the patient to close his eyes and to 
inspire deeply, and when the period of excitement comes on 
do not suspend the inhalation, but keep the towel firmly ap- 
plied to the face until calm sleep is produced, or the slightest 
indication of stertor is heard. Complete anesthesia is 
proved by the abolition of reflex action, as shown by insen- 
sibility of the eye when the cornea is lightly touched with 
the finger, by muscular relaxation, and by insensibility to 
pain. 

4. [IF the action of the heart seems to fail, remove the 
chloroform and administer ether vapor for a few respirations. 
Do not give anything by the mouth. If the respiration 
be languid and intermit, assist the movements by gentle 
pressure on the chest and abdomen. If the natural respira- 
tion has ceased and the pulse is not distinctly felt, at once 
resort to the more effective artificial respiration of Marshall 
Hall or Howard. Warmth should also be applied by the 
readiest means ; galvanism, etc. C] 

"When the operation is over, let the patient recover natu- 



CHLOROFORM. 209 

rally, and do not disturb his sleep by the purposeless towel 
flickings so frequently to be seen in operating theatres. 
But the patient should be carefully watched for at least an 
hour after administration. 

As regards the quantity of chloroform to be used for each 
inhalation, it is impossible to lay down any rule, for the in- 
conveniences occasionally met with seem to bear no sort of 
proportion to the dose of the anaesthetic. [A couple of 
drachms may be poured from a dropping bottle upon the 
towel, and a few drops added from time to time to replace 
loss by evaporation. The chloroform should never be 
trusted to any but a skilled assistant.] If the chloroform be 
of good quality, it is safer, as shown by Brunton, to give it 
freely, 1 and it is better to trust to- our own care and skill 
than to the fancied safety of inhalers. It can never be pos- 
sible to deprive an unnatural condition like profound anaes- 
thesia of all dangers, and even the theoretically safe instru- 
ment of Clover, with its guaranteed 3 per cent, of chloroform 
vapor, has been shown to be not absolutely free from risks. 2 

It would be very satisfactory could we lay down any laws 
for our guidance in anticipating danger from chloroform in- 
halation in any special class of cases, but this unfortunately 
we cannot do. It is now well known that neither organic 
disease of the heart nor conditions of extreme debility are 
contra-indications ; and although fatty heart is frequently 
discovered post-mortem, w r e cannot absolutely state that this 
is not a mere coincidence, nor can we pretend to diagnose 
such degeneration with any certainty during life. Some 
authorities believe that chloroform is more dangerous to the 
old than the middle-aged or young, and there seems no doubt 
that habitual topers are brought under its influence with 
considerable difficulty. 

Chloroform is most generally given internally under the 

1 [Surely Brunton's views hardly warrant so much indifference 
to the dose of chloroform. The tendency to syncope is found to be 
in proportion to the strength of the vapor, whenever, by opening 
the windpipe, we make sure of its entrance into the lungs. Ten 
per cent, of chloroform vapor, giv T en in this way, is rapidly fatal 
by arresting the heart's movement. The reason why chloroform 
has often been fatal in minor operations is, that it so often happens 
an extra dose is given that it may last long enough without further 
attention from the surgeon. C] 

2 [I am not acquainted with any case in which so little as 3 per 
cent, has been fatal to the human subject. C] 

18* 



210 IRISH MOSS — CINCHONA. 

form of the spiritus chloroformi, or chloric ether, or as mis- 
tura chloroformi. [For the remarks of Mr. Clover upon the 
choice of anaesthetics, see page 48.] 



[CHONDRUS— IRISH MOSS. 

Chondrus crispus, U. S. 

Carrageen is demulcent and nutritive, and is used in de- 
coction (Jss to Oiij) flavored with lemon, as a ptisan or 
drink for the sick. Boiled with milk it makes carrageen 
blanc mange, an acceptable and nourishing article of diet for 
an invalid.] 



CIMICIFUGA— BLACK SNAKEROOT. 

[ The root of Cimicifuga racemosa, U. S. 
Officinal Preparation, U. S. 

Extractum Cimicifuga^ Fluidum. Dose, f3ss-j 
(2. to 4. Gm.). 

The decoction, although not officinal, has been used to 
a considerable extent, and with benefit, in the treatment of 
chorea in children. It is sedative and antispasmodic, and 
in large doses vomits.] 

This drug was introduced into practice in this country 
[England] some years ago by Sir J. Simpson, who praised 
it highly in chronic rheumatism, lumbago, and hypochon- 
driacal depression. It has been found useful in America as 
an emmenagogue, but has never taken any real hold upon 
professional attention at home. 

Dose of the tincture [Br.], 10 to 30 minims. 



CINCHONA—CINCHONA. 

[Syn. Peruvian Bark; Cinchona Bark. The bark of all species of the 
genus Cinchona, containing at least two per cent, of the proper cinchona 
alkaloids, which yield crystalline salts, U. S. 

Varieties. 

Cinchona Flava. The bark of Cinchona calisaya, 
U. S. 

Cinchona Pallida. The bark of Cinchona Condami- 
nea, and of Cinchona micrantha, U. S. 



CINCHONA. 211 

Cinchona Rubra. The bark of Cinchona succirubra, 
U. S. 

Officinal Preparations, U. S. 

Of the Yellow Bark :— 

Cinehonia^ Sulphas. Dose, gr. ij-xxx (.12 to 2. Gm.). 

Decoetum Cinchonas Flavs. Dose, fgij-iv (64. 
to 128. Gm.). 

Extraetum Cinchonas. Dose, gr. v-xv (.30 to 
1. Gm.). 

Extraetum Cinchonas Fluidum. Dose, gtt. v-xv 
(.30 to 1. Gm.)- 

Infusum Cinchonas Flav®. Dose, f §ij (64. Gm.). 

Quinia? Sulphas. Dose, gr. ij-xx (.12 to 1.30 Gm.). 

Pilula^ Quiniffi Sulphatis (each gr. j). 

Tinetura Cinchonas. Dose, i'3j-ij (4. to 8. Gm.). 

Of the Red Bark :— 

Decoetum Cinchonas Rubral. Dose, fj§ij-iv (64. 
to 128. Gm.). 

Infusum Cinchonas Rubral. Dose, f§ij (64. Gm.). 

Tinetura Cinchonas Composita (Huxham's tinc- 
ture). Dose, f*3J — ij (4. to 8. Gm.).] 

Effects and Uses. 

In any comparative estimate of the absolute importance 
of various drugs to the human species, cinchona would 
probably take the second place, the tirst being, by universal 
consent, accorded to opium. The bark itself, however, is 
not now of so much importance as in former years, when it 
was our sole dependable remedy for the poison of ague, and 
was then given in such enormous quantities as to be very 
embarrassing to the weak stomachs of feverish patients. 
This difficulty is now happily removed, and much greater 
precision and efficiency given to our treatment, by the intro- 
duction of quinine, the discovery of which in 1820 inaugu- 
rated a true era in therapeutics. 

The preparations of cinchona are now used almost exclu- 
sively on account of their tonic properties, and in many cases 
of general debility, want of appetite, and loss of tone, most 
gratifying results are obtained by their employment either 
singly or in combination. Quinine itself, however, has a 



212 



CINCHONA. 



higher and wider therapeutic range, and has in recent years 
obtained so much of the careful attention of physiologists 
that we are bound to consider its properties with as much 
care and precision as the present state of science allows. 

Local Action. 

Quinine is occasionally, although rarely, used as a local 
application ; but the theory of this is so intimately bound up 
with its internal use, that we need not refer specially to it at 
present, save to note that an injection of gr. ij ad ^j has 
been found of great service in checking the unhealthy secre- 
tion of an irritable bladder. 



Internal Action. 



Physiological. 

1. Nervous System 1. 

Brain Quinine in large 

doses causes curious brain 
symptoms, such as partial 
blindness, well-marked deaf- 
ness and ringing in the ears, 
giddiness, and frontal head- 
ache, associated with a pecu- 
liarly dull, heavy expression 
of countenance. Binz has 
suggested that some at least 
of these phenomena may be 
due to partial anaemia of the 
brain, caused by enfeebled 
action of the heart. Ham- 
mond, on the contrary, as- 
serts that quinine causes con- 
gestion of the brain. Gubler 
asserts that it stimulates the 
great sympathetic and audi- 
tory nerves. 

It contracts the uterus. 

2. Spinal System In 

frogs, quinine acts powerfully 
in reducing the reflex irrita- 



Therapeutical. 

I. The subcutaneous injec- 
tion of quinine has been 
highly recommended by Sur- 
geon-Major Hall in sun- 
stroke. 

This mode of administer- 
ing the drug, however, is not 
unfrequently followed by in- 
flammation and even abscess 
at the seat of puncture. 
Gubler prefers the. brom- 
hydrate to the sulphate, as 
being less irritating and bet- 
ter adapted for use in this 
way. 1 

The oxytocic action of qui- 
nine must be, in part at least, 
due to its action on the ner- 
vous system ; but its un- 
doubted power in contracting 
the uterus has not yet been 
much used in medicine. [It 
appears to be appreciated in 
the United States. Here it 
is frequently used as a par- 



1 A hypodermic injection of sulphate of quinia has caused teta- 
nus. See National Dispensatory, Phila. 1879, p. 1179. 



CINCHONA. 



213 



bility of the cord, the animal 
lying motionless, quite insen- 
sible to external impressions, 
the stillness being only 
broken by occasional tetanic 
spasms ; but this action is 
contradicted by the more re- 
cent experiments of Binz. 

II. On Vascular System. 
— Moderate doses cf quinine 
increase the frequency of the 
pulse, but, if larger quantities 
be given, the rate of pulsa- 
tion falls, the arterial tension 
diminishes, and death may 
even ensue from convulsions 
or sudden collapse following 
depression of the heart's ac- 
tion. 

Quinine has a direct action 
on the white corpuscles of the 
blood, checking their amoe- 
boid movements, and arrest- 
ing their tendency to migrate 
through the walls of the ca- 
pillaries under inflammatory 
conditions. 

It also prevents, in some 
degree, the due giving up of 
oxygen by the red corpuscles, 
and may thus interfere with 
the oxygenation of the tissues. 

III. Respiration and Tem- 
perature No influence on 

the respiratory function has 
been observed. On the tem- 
perature of a person in full 
health but little lowering 
effect is produced ; when fever 
is present, however, the tem- 
perature may be brought 
down by giving large doses. 
Opinions differ so much as 



turifacient in single doses of 
gr. x— xv.] It has, however, 
been asserted that it may be 
injurious to the foetus. 



II. Quinine has therefore 
some stimulating properties. 
It has been shown to be a 
valuable remedy in 8 to 15 
grain doses, in combination 
with potassic iodide in cases 
of specific and non-specific 
serpiginous and phagedenic 
ulceration, after the failure of 
other remedies. 

An essential part of in- 
flammation and suppuration 
is now known to be extrusion 
of the white blood corpuscles 
from the capillaries, and their 
subsequent transformation in- 
to pus-cells. Quinine may 
therefore be of great service 
in localized inflammations, 
and in checking exhausting 
discharges from abscesses or 
wounds, and in pyaemia good 
results have followed its use. 

III. The antipyretic pro- 
perties of quinine are much 
prized in Germany, and it is 
there largely used in the 
treatment of typhus, typhoid, 
acute rheumatism, and pneu- 
monia. 

Immense doses, even reach- 
ing 75 grains, have been 
given, and it is observed that 
tolerance of the drug is un- 



214 



CINCHONA. 



to the explanation of this 
effect, that it is impossible to 
speak with any confidence on 
the question. [According to 
Henbach the cause of death 
in animals poisoned with 
quinia is a paralytic arrest of 
respiration.] 



IV. On Secretion. — In 
moderate doses, quinine in- 
creases the secretion of sa- 
liva, and augments, like most 
bitters, the flow of gastric 
juice, stimulating the appe- 
tite at the same time. 

If larger quantities, how- 
ever, are taken, an exactly 
opposite effect is produced ; 
hunger is blunted, and the 



doubtedly present in fever, 
and that very much larger 
quantities can be taken than 
in a state of health. It is 
only when very freely given, 
however, that it has any cool- 
ing influence ; and we are 
advised to prescribe from 25 
to 45 grains in divided doses 
within the first half hour, and 
then allow an intermission of 
from 24 to 48 hours, as the 
effect would be diminished 
by spreading it over a longer 
time, on account of its rapid 
elimination. 

In this country we do not 
make very extensive use of 
quinine in febrile disorders, 
for the resulting diminution 
of temperature is only tem- 
porary, and has no influence 
on the progress of the dis- 
ease. When a really dan- 
gerous degree of pyrexia is 
reached, we know that we 
can hold it readily in check 
by cold baths. [But where 
hydropathic treatment is in- 
admissible, quinia in full 
doses is an efficient anti- 
pyretic] 

IV. Quinine is the best 
tonic we possess, increasing 
the appetite, and bracing up 
the intestinal mucous mem- 
brane. It is given, therefore, 
in all states of the system 
where debility is present, in 
simple loss of appetite, in 
some forms of dyspepsia, in 
neuralgia, especially of the 
supra-orbital nerve, in conva- 



CINCHONA. 



215 



alkaloid, acting as an irritant 
to the mucous membrane of 
the stomach, checks the gas- 
tric juice. The urine is found 
to be unaltered in quantity, 
but the amount of uric acid 
and probably of urea given 
off is decidedly diminished. 

V. Quinine is an excellent 
antiseptic, preventing and ar- 
resting decomposition. This 
it does in virtue of its poison- 
ous influence over minute or- 
ganisms, for we know that the 
process of decay is caused by 
the formation and rapid mul- 
tiplication, within the putre- 
fying fluid, of microscopic 
bodies called microzymes. 
Quinine in small doses para- 
lyzes, and in larger, destroys, 
these creatures, and so at 
once arrests further destruc- 
tive action. 

Some authorities have been 
inclined to explain its remark- 
able influence over ague by 
theoretically supposing that 
the essence of the malarial 
poison really consists in a 
minute germ or vegetable cell 
derived from the marshy land 
where the pestilence breeds, 
and that the antiseptic prop- 
erty of the drug is here the 
true explanation of its thera- 
peutic success. 

This seems to be borne out 
by the recent observations of 
Lanzi and Zerner, who have 
found an identical fungus in 
the decaying vegetation of 



lescence from acute disease, 
to arrest the nocturnal sweat- 
ing of phthisis, etc. 



V. In virtue of this poison- 
ous influence over protoplasm 
and minute germs, it has been 
recommended in large doses 
in whooping-cough, on the 
ground of destroying the vi- 
tality of the thick and tena- 
cious mucus which causes so 
much irritation in the bron- 
chial tubes, or, as others hold, 
by destroying the minute fun- 
gus on which the disease de- 
pends. [Henke.] Again, in 
hay-fever, which is now proved 
to result from the local action 
on the Schneiderian mucous 
membrane of the pollen of par- 
ticular grasses, Prof. Helm- 
holtz has lately pointed out 
that quinine applied in the 
form of snuff or strong solu- 
tion [gr. j-f 3j], will effect a 
speedy cure. 



216 CINCHONA. 

the Roman Campana and in 
the tissues of the victims to 
malaria. 

Specific Action. 

Quinine has what, for want of a better explanation, we 
must call a specific control over all malarial fevers and dis- 
eases which display any periodical tendency. Gubler, how- 
ever, denies all specific influence, and believes that it acts by 
giving tone to the sympathetic nerve, thus enabling it to re- 
sist the attack of the malarial poison. Binz, on the con- 
trary, denies all neurotic explanations, and holds its effects to 
be due to its paralyzing action on the septic processes caused 
in the blood and tissues by a ferment from decaying vegeta- 
tion, whose further chemical development is thus arrested. 

Now quinine may act as a prophylactic, and, given in 
moderate doses at regular intervals, may ward off attacks ; 
and this fact is extensively taken advantage of by African 
travellers and troops stationed in malarial districts, to whom 
rations of quinine are invariably served out. When the dis- 
ease, however, is fairly developed, quinine will keep it in 
check and even arrest its progress ; and this either yi smaller 
doses frequently repeated, or in one considerable dose taken 
shortly before the attaek is expected. 

The periodical return of the paroxysms of shivering, heat, 
and sweating, enables us to calculate with accuracy the very 
hour of the day at which to expect their recurrence ; and 
experince has determined that the best mode of treatment is 
to give one full dose of 10 or 20 grains half an hour before 
the attack comes on. 

The remarkable enlargement of the spleen which attends 
intermittent fever is often so rapidly diminished by quinine 
as to make it probable that the reduction of bulk is due to 
an active contraction of the substance of the organ itself. 

Another curious point about the action of quinine is, that 
whilst it may check the rigors and rise of temperature 
attending the aguish paroxysm, the quantity of urinary water 
and urea excreted may be as much increased as they always 
are during the attack. 

Quinine is also an invaluable agent in some of those affec- 
tions which, without belonging directly to the aguish cate- 
gory, have something of the intermittent quality impressed 
on them ; for example, we often find that neuralgia and 



CINCHONA. 217 

various forms of headache are distinctly periodic, and return 
at regular intervals. In such cases quinine works wonders, 
and may effect a cure with almost magical rapidity. 

Mode of Elimination. 

Quinine, being possessed of considerable diffusive power, 
rapidly enters the blood, and is rapidly given out. It may 
be found in the urine in 30 minutes after ingestion ; elimina- 
tion is at its height in 2 or 3 hours, diminishes in 24 hours, 
and ceases in three days. Although traces of its presence 
have been found in the saliva, sweat, and intestinal secre- ' 
tion, it is by the urine that the greater part, probably about 
two-thirds, is given off, and according to some authorities, 
the sulphate is converted into a different allotropic form, 
partly amorphous, and quite inert, which has been called 
quinicine. 

Disadvantages of its Use. 

In addition to the headache, deafness, ringing in the ears, 
and other physiological phenomena, already noted, a good 
many cases have now been recorded of eruptions on the 
skin. In some of the quinine manufactories abroad, ecze- 
matous eruptions are observed in the workmen employed, 
and its internal administration has been occasionally fol- 
lowed by a bright-red, scarlatinoid rash, accompanied by 
intolerable itching and smarting and followed by copious des- 
quamation, or, more rarely, by a rubeoloid eruption, rather 
suggestive of urticaria, and attended with marked gastric 
derangement, a curious point being that these unpleasant 
effects have usually followed very small doses, sometimes of 
only a simple grain. Urinary irritation is also occasionally 
produced, more especially in the old, and consisting of dys- 
uria, renal congestion, and even hemorrhage. And we must 
remember that idiosyncrasy here plays an important role, 
and that some persons cannot take a single grain without 
inconvenience. 

Therefore, as before advised, it is always well, before pre- 
scribing quinine, to ask our patient if he has ever taken it 
before. 

19 



218 cinchona. 

Mode of Administration and Dose. 

This salt is best prescribed in mixtures with a little nitric 
or dilute sulphuric acid, as tinctures do not dissolve it well ; 
though, as Ringer says, it is really unnecessary to combine 
acid, as the quinine is readily soluble in the acid of the gas- 
tric juice. But a little acid makes a more elegant mixture, 
by removing that turbidity which a certain quantity of the 
undissolved alkaloid necessarily imparts to a solution. The 
dose varies from about gr. j, which is the usual tonic dose, 
to 10, 20, 30 grains, or even more ; and although in this 
country a larger quantity than 10 grains is perhaps rarely 
prescribed, it is clearly absurd to put the maximum dose, as 
in the British Pharmacopoeia, so low as this. 

A good way of obviating the headache and ringing in the 
ears, is by adding to each dose ni^xxx of hydrobromic acid, 
which is also a good solvent. 

[To avoid the bitter taste of quinia is absolutely necessary 
in some cases. For this purpose it is sometimes ordered in 
sugar-coated pills, or inclosed in cachets de pain. The powder 
may be given to children in a spoonful of syrup of red orange, 
or mixed with honey or molasses ; it may also be taken in 
coffee, or simply suspended in cold water, or the powder 
sprinkled over the cut surface of an orange. The quinia may 
be enveloped in tissue paper and twisted tightly into a ball ; 
a little practice will enable an adult to deftly swallow 
such a bolus without tasting, and with but little inconve- 
nience. The aromatic elixir of glycyrrhizin has been re- 
commended as the best vehicle for the administration of 
the sulphate of quinia ; l but preparations containing licorice, 
such as the officinal fluid extract of taraxacum, or the com- 
pound licorice mixture, are quite satisfactory for this pur- 
pose. Tannin has the power of disguising the taste of quinia, 
and, according to Rolander, it does not detract from its thera- 
peutic properties. The following formulae will be found use- 
ful for the administration of quinia in solution : — 

For children — 



R. Quimse sulphatis gr. xxiv ; or 1 

Acidi taimici 5ii '■> "8 

Syr. cinnamomi f'giij \ "96 

S. Capiat cochleare parvum ter in die. 



50 Gm. 

u 

M. 



1 Remington, Med. and Surg. Rep., vol. xxxvii. p. 88, Phila., 

1877. 



CINCHONA. 219 



Or, as the disulphate — 

R. . Quinise sulphatis gr. xxiv ; or 1 

Acidi sulphurici dil. f£j ; "4 

Tr. cardomomi co. f 3iij ; "12 

Syrupi q. s. ad f §iij ; "96 

S. Dose, f5j. 



50 Gm. 



M. 



Or, in a cough mixture — 

U. Quinise sulphatis gr. xxiv ; or 1!50 Gm. 

Acidi sulphurici dil. q. s. ad solve ; 

Mist, glycyrrhizse co. ad f ^iij ; " 96 1 " M. 
S. Dose, a teaspoonful. 

In the declining stage of whooping-cough. 

For adults, any of the preceding prescriptions may be 
used, or we may give the following : — 

R. Quinise sulphatis gr. xlviij ; or 320 Gm. 

Acidi sulphurici dil. q. s. ; 

Syr. limonis f^ij ; "64 " 

Aquae q. s. ad f|vj ; "192 " M. 

each drachm containing one grain of quinia. A more plea- 
sant preparation would probably be obtained by substituting 
Cura^oa cordial for the lemon syrup. As a tonic carmina- 
tive the following proves very acceptable in weakened 
digestion : — 

R. Quinise sulphatis gr. xlviij ; or 3120 Gm. 

Acidi sulphurici dil. q. s. ad solve; 
Tr. gentianse comp. f§iv; " 128 " 

Syr. zingiberis q. s. ad f^vj ; " 1921 " M. 

S. Dose, a dessertspoonful before meals. 

Wine of aloes may be appropriately added, should consti- 
pation be present in the case.] 



. Quinise sulphatis 


gr. viij ; 


or 




50 Gm. 


Acidi nitrici diluti 


f3ss; 


it 


2 


it 


Tincturse aurantii 


f §ss ; 


a 


16 


cc 


Syrupi aurantii eort. 


f§j; 


it 


32 


It 


Aquse 


ad fgvnj ; 


a 


256 


11 



M. 

S. Dose, f ^j ter die sumend. 

For a case of debility and want of appetite. 

Some persons, who object to sweets, prefer the syrup to 
be left out ; but it will usually be found an agreeable addi- 
tion. Quinine may also be given in the form of simple 
powder, dissolved in a glass of sherry, and when a large 



220 CINCHONA. 

dose, such as 10 grs., is prescribed, it is more conveniently 
taken in simple suspension in distilled water. A very com- 
mon plan is to order quinine with acid infusion of roses, but 
Squire has pointed out that a turbid and unsightly mixture 
is thus produced from the resulting tannate of quinine being 
insoluble in sulphuric acid ; whereas if the infusion be made 
with nitric acid, the mixture is " bright and attractive in 
appearance." 

Under the name of Warburg's tincture, a secret prepara- 
tion of unusual complexity has recently been made public, 
and has been most highly recommended by Maclean in tropi- 
cal diseases, and by Broadbent in cases of shock and col- 
lapse. Under its use free perspiration sets in, and the tem- 
perature goes down, and it is believed that the action of the 
drug is materially aided by the powerful aromatics with 
which it is combined and the state of concentration in which 
it is given. Each one-ounce bottle contains 9^- grains of 
quinine, and it is best given on an empty stomach after pre- 
liminary evacuation of the bowels, the ounce being taken 
undiluted and repeated in 2 or 3 hours. 

Other Preparations. . 

In addition to quinia other alkaloids and substances have 
been detected in bark, some of which are of use in medicine. 
We have : — 

1. Quiuic or kinic acid. 

2. Quino-tannic acid. 

Quinetum is the collected alkaloids of bark, and has been 
found to be very efficacious in chronic cases of ague. 

3. Cinchona red. 

4. Kinovin. 

These four have no therapeutic significance. 

5. Cinchonia has some febrifuge power [and sulphate of 
cinchonia can in many cases take the place of quinia as an 
antiperiodic, at about one-eighth the cost]. 

6. Quinidia has been reported as nearly equal to quinine 
in the foregoing respect [and is an efficient substitute for the 
more expensive salt]. 

7. Cinchonidia is only a little efficacious, but causes an 
unpleasant dryness of the mouth. 

None of these preparations have been able to completely 
take the place of quinine, as they are weaker, less certain in 



CINNAMON. 221 

action, and less agreeable ; and quinine, notwithstanding its 
comparatively high price, still retains its position as our most 
reliable antiperiodic. 

The preparations of cinchona, as we said before, are prin- 
cipally used for their tonic properties ; and there is perhaps 
no more pleasant and effectual medicine of this class than 
the ordinary tincture of bark, whilst the decoction or infusion 
is in very general use as a vehicle for more active drugs. 

[The elixir of cinchona flava, though not officinal, is an 
elegant preparation, and is much used. Dose, f jfss-ij.] 

Tinctura cinchonas composita [Huxham's tincture] con- 
tains powdered red bark, Jbitter orange-peel, serpentaria, 
saffron, cochineal, and proof spirit. [It is a valuable tonic 
and stomachic] 



CINNAMOMUM— CINNAMON. 

[The prepared bark of Cinnamomum Zeylanicwn (Nees Laurin), and of 
Cinnamomum aromaticum {Nees, ibid.), U. S. 

Oleum Cinnamomi. Dose, gtt. j-ij (.06 to .12 Gm.). 

Officinal Preparations, U. S. 

Tinetura Cinnamomi (gjss to Oj). Dose, fjj-ij 
(4. to 8. Gm.). 

Aqua Cinnamomi — as a vehicle. 

Pulvis Aromatieus (cinnamon and ginger each 2 
parts, cardamom and nutmeg each 1 part). Dose, gr. x-xx 
(.60 to 1.30 Gm.). 

Confeetio Aromatica (pulv. aromat. and honey). 

Spiritus Cinnamomi (oil gj in Oj). Dose, f£j-ij 
(4. to 8. Gm.). 

Also enters into Acidum Sulphuricum Aromaticum, In- 
fusum Catechu Compositum, Spiritus Lavandulae Compositus, 
Syrupus Rhei Aromatieus, Tinctura Cardamomi Composita, 
Tinctura Catechu, and Vinum Opii.] 

Cinnamon is principally used for flavoring purposes, but 
also seems to have slight astringent properties, which make 
it useful in diarrhoea. [It has been also strongly recom- 
mended in uterine hemorrhage, given in substance, or as a 
decoction made with milk.] 

19* 



222 COCHINEAL — COLCHICUM. 

[COCCUS— COCHINEAL. 

The female of Coccus cacti, U. S. 
It enters into Tinctura Cardamomi Composita. 

Cochineal has been considered to possess antispasmodic 
and anodyne properties, and has been recommended in 
whooping-cough (gr. ^, s. t. d., to infants) combined with 
carbonate of potassium. It is also used in neuralgia. In 
pharmacy it is used as a coloring agent.] 



[COLCHICUM— COLCHICUM. 

Colehiei Radix. The corm of Colchicum autumnale, 
U. S. 

Colehiei Semen. The seed of Colchicum Autumnale, 
U. S. 

Officinal Preparations, U. S. 

Extractum Colehiei Aeetieum (of the root). 
Dose, gr. j-ij (.OG to .12 Gm.). 

Extractum Colehiei Radieis Fluidum. Dose, 
Tt^ij-iv (.12 to .24 Gm.). 

Vinum Colehiei Radieis (Jvj to Oj). Dose, gtt. 
x-xv (.60 to 1. Gm.). As a purgative, TTl.xxx (2. Gm.). 

Extractum Colehiei Seminis Fluidum. Dose, 
Tljvi-vj (.12 to .40 Gm.). 

Tinctura Colehiei (of the seeds, ^ij to Oj). Dose, 
TTliv-xx (.25 to 1.25 Gm.). 

Vinum Colehiei Seminis (of the seeds, gij to Oj). 
Dose, 3 ss ~j (2- t0 4. Gm.).] 

Internal Action. 

Physiological. Therapeutical. 

The leading physiological As the experiments of 

action of colchicum is un- Rutherford have shown that 

doubtedly directed to the in- colchicum increases the bil- 

testinal canal, large doses iary secretion, it may be a 

causing free vomiting and useful adjunct to cholagogue 

copious purging of yellowish pills, although its own purga- 



COLCHICUM. 



223 



feces containing a large 
quantity of bile. The action 
of the heart is usually some- 
what depressed, and it has 
been stated that the urinary 
secretion is augmented, but 
of this there is no very clear 
proof. 

[Colchicum increases the 
proportion of the urea and 
uric acid, as well as the 
amount of urine excreted by 
the kidneys, according to 
Prof. Christison, Dr. Mac- 
lagan, and others ; but, on 
the other hand, this is denied 
by Gubler. 

The active principle is an 
alkaloid, colchicia, which is 
from 80 to 100 times stronger 
than the fresh corm.] 



tive action is too violent to be 
available for this purpose. 

Its principal use is as a 
remedy for gout, more espe- 
cially the acuter forms, and 
here it never fails to remove 
pain rapidly, without, how- 
ever, in any way lessening 
the tendency to future at- 
tacks. How it acts is un- 
known, and we can only call 
it a specific. Some good au- 
thorities, however, contest 
this effect, believing it to act 
merely as a palliative ; and 
that, in order to get its full 
influence, at least 3 or 4 stools 
a day must be produced. It 
is believed to be cumulative. 
It is also very valuable in 
various diseases of gouty 
parentage, as in some forms 
of dyspepsia, bronchitis* etc. ; 
but in acute rheumatism it 
has been proved to exert 
rather a noxious than a bene- 
ficial influence. 



Dose and Mode of Administration. 

Colchicum may be given either in one or two full doses, 
or in smaller quantities spread over a longer time. Of 
these plans the former is probably the more effectual in an 
acute attack of gout. The following formulse are suitable 
for various gouty conditions :• — 



K 


Tincturae colcliici 


1T\xx; 


or 


1 


30 Gm 




Potassii bicarbonatis 


gr. x ; 


a 




60 " 




Aquae pimentae [Br.] 


f§j; 


a 


32 


a 


Misce, fiat haustus ter die sumendus. 






R. 


Tincturae colchici 


ttlxv; 


or 


1 


Gm 




Magnesii carbonatis 


gr. vj ; 


a 




40 " 




Magnesii sulphatis 


gr. xxx ; 


a 


2 


it 




Aquae menthae piperita? 


ad f Jj ; 


a 


32 


n 


s. 


Ter die sumendus, 











M. 



224 



COLOCYNTH. 



]$ . Extracti colchici acetici gr. x ; or 

Pulveris digitalis, 

Extracti colocynthidis comp. aa ^j ; u 1 

Misce, fiant pilulae xx. Sumat imam bis terve in die. 

I£. Potassii iodidi, 

Ammonii carbonatis aa 9j ; 

Vini colchici f 3j ; 



or 



S. 



Tincturse scilloe, 
Tincturse hyoscyami, 
Aqua? camphorse 
f 5ss ter die. 



aa f 3ij 

ad f §iij ; 



8 
96 



60 Gm. 
30 " 

30 Gm. 



M. 



Dr. Greenhow's formula for gouty bronchitis. 
[Scudamore's mixture : — 
R. 



Magnesii sulphatis 


ij-ij ; 


or 


32 


Magnesia? 


5lb gr. xl ; 


i i 


10 


Aceti colchici [Br.] 


f§j-jss ; 


a 


32 


Syrupi croci [Br.] 


ffj; 


it 


32 


Aqua? nientha? pip. 


f^x; 


i i 


320 



Gm. 



60 



" M. 

Dose, f :§ss-jss repeated every 2 hours in a paroxysm of gout 
until from four to six evacuations are produced in the 24 hours. 

The Acetum colchici was omitted from the Pharmacopoeia 
in the last revision. It was made from the conn, and was 
only one-third the strength of the officinal wine of colchicum 
root.] By contact with acids, even those of wine, or vinegar, 
colchicine is transformed into colchiceine, a neutral glucoside 
of very inferior strength ; and alcohol, which has no such 
converting power, is therefore the best solvent. 



COLOCYNTHIS— COLOCYNTH. 

[ The fruit, deprived of its rind, of Citrullus Coloct/ntJus, U. S. 

Officinal Preparations, U. S. 

Extraetum Colocynthidis (alcoholic). Used only 
in combination. Dose gr. ij-v (.12 to .30 Gm.). 

Extraetum Colocynthidis Compositum. Dose 
gr. v-xxx (.30 to 2. Gm.). 

Pilulae Cathartieae Composite. Dose 1-3 pills.] 

Physiological Action. Therapeutical Action. 

Colocynth produces a good Colocynth is a drastic pur- 

deal of irritation of the large gative, rapid and efficient in 
intestine, causing profuse its action, and much used 



HEMLOCK. 225 

watery evacuations, and, if as an ordinary remedy in 

given in excessive dose, even habitual constipation and 

proving fatal by inflammation various dyspeptic conditions, 
and ulceration. It is found, Rutherford's recent expe- 

however, that its drastic ac- riments have proved colocynth 

tion, as well as the griping to to be a powerful stimulant 

which it occasionally gives both of the hepatic secretion 

rise, may be obviated by and of the intestinal glands, 
combination with aromatics 
and other purgatives. 

Mode of Administration. 

Colocynth is rarely, if ever, prescribed alone. The offi- 
cinal compound extract or pill, containing, in addition, aloes 
and scammony, is a useful formula ; but the best mode of 
combination is undoubtedly that with either hyoscyamus or 
belladonna. 



[Confeetiones. 

The officinal Confections are : — 

Confectio Aromatica Confectio Rosa? 

" Aurantii Corticis " Sennae.] 

" Opii 



CONIUM— -HEMLOCK. 

["Conii Folia. The leaves of Conium maculatum, U. S. 
Conii Fruetus. The full-grown fruit of Conium macu- 
latum, gathered while yet green and carefully dried, U. S. 

Officinal Preparations, U. S. 

Extraetum Conii Fruetus Fluidum. Dose, 
ttti-v (.06 to .30 Gm.). 

Extraetum Conii (of the leaves). Dose, gr. j-iv (.06 
to .25 Gm.). 

Extraetum Conii Alcoholicum (of the leaves). 
Dose, gr. j— ij (.06 to .12 Gm.). 

Sueeus Conii. 1 Dose, f'5ss-j (2. to 4. Gm.). 

1 [The class of Succi, U. S. P., only comprises Succus Conii and 
Succus Taraxaci.] 



226 



HEMLOCK. 



Tinetura Conii (^ij to Oj). Dose, f5ss~j (2. to 4. 
Gm.\ 

Test — Methyl-Conia, the active principle of conium, when 
liberated from its combinations by potassa, is volatile, and 
exhales a strong mouse-like or urinous odor. With the vapor 
of muriatic acid, it forms dense white fumes. The odor of 
conia is so characteristic, that it can scarcely be confounded 
with any other poisonous agent. 

Antidote. 
Atropia has been suggested as a physiological antidote.] 

Local Action. 

Conium has been occasionally used in the form of poultice 
as an application to cancerous sores or tumors, and it is said 
that the severe lancinating pain common to these affections 
may thus be mitigated. 



Internal Actions. 



Physiological. 

1. On Nervous System 

1. Brain No effect is pro- 
duced on the brain proper, 
it having been observed in 
cases of poisoning, and 
notably in that of Socrates, 
and in a patient under Prof. 
Bennett's care, that the in- 
tellectual faculties are quite 
unimpaired to the last. 

Dr. John Harley, however, 
is of opinion that a consider- 
able portion of the action of 
conium is expended on the 
motor ganglia, and more es- 
pecially the corpus striatum. 

2. Spinal Cord. — Pure 
conium has no special influ- 
ence on the spinal nervous 
system, but an alkaloid, 

METHYL-CONIA, which it 



Therapeutical. 



I. To this action Dr. Har- 
ley ascribes the beneficial in- 
fluence of conium in chorea. 
Although in many cases we 
may derive real advantage 
from this remedy, it often 
fails, and in order to insure 
the full amount of benefit we 
must use large doses, and see 
that the drug is pure. Dr. 
Harlev also recommends it in 



HEMLOCK. 



227 



usually contains, has been 
proved to cause first exalta- 
tion, and finally depression, 
of the reflex function of the 
cord. [Dr. Christison thinks 
"that it acts upon the spinal 
marrow, directly prostrating 
the nervous power, producing 
paralysis of the voluntary 
muscles, and destroying life 
by arresting respiration."] 

3. On the Nerves Herein 

lies the true physiological 
action of conium. It acts 
first on the third nerve, 
causing drooping of the eye- 
lid, dilatation of the pupil, 
and sluggish and impaired 
movement of the eyeball. 
The influence then spreads 
to all the other motor or 
afferent nerves. A sensation 
of weight and enfeeblement 
of the legs, followed by stag- 
gering, is first experienced, 
and finally total paralysis is 
developed, the victim being 
entirely unable to move ; and 
so complete may this become, 
that asses in Italy which have 
fed on hemlock have been 
flayed alive without the pos- 
sibility of resisting in any 
way. This paralyzing influ- 
ence is at first confined to 
the terminal extremities of 
the nerves. 

The sensory nerves are 
quite unaffected. 

II. Vascular System. — 
No effect is produced on the 
heart or circulation. 

III. Respiration and Tem- 



the nervous twitchings met 
with in some cases of hemi- 
plegia. Conium has been 
given with some benefit in 
the convulsions of children. 

[From 10 to 15 drops of 
the alkaloid has caused 
death.] 



3. Dr. Harley recom- 
mends its use in the violent 
spasm of the orbicularis met 
with in keratitis, but I have 
been unable to confirm this 
after careful trial. 

The remarkable power of 
conium in effecting muscular 
relaxation would indicate its 
use in a variety of spasmodic 
conditions. Thus, in laryn- 
gismus stridulus, trismus, 
spasmodic wry neck, spas- 
modic stricture [hysteria, 
and insanity'], and perhaps 
in the reduction of hernia 
and dislocation where any 
contra-indication to the use 
of anaesthetics exists, it seems 
worthy of trial ; and Dr. 
Handfield Jones recommends 
it highly in paralysis agi- 
tans. It must, however, be 
confessed that the therapeu- 
tical success of conium by no 
means comes up to its phy- 
siological promise. 

Dr. Crichton Brown has 
seen good results from the 
use of conium in mania with 
violent motor excitement, in 
which it restrains the violent 



228 HEMLOCK. 

perature The breathing is muscular movements ; and 

at first unaffected, but, as the Dr. R. Burman - has used 
poisonous action of the drug conia by subcutaneous injec- 
goes on, the paralysis spreads tion successfully in the same 
to the respiratory centre, and class of cases, 
death ensues from asphyxia. 

Some lowering of the tem- 
perature has been observed. 

IV. Secretion — No influ- 
ence on secretion has been 
notedi 

Mode of Elimination. 

The presence of conium has been detected in the blood, 
and its elimination is effected by the breath and urine, but 
principally by the latter. 

Mode of Administration, Cautions, etc. 

It having been satisfactorily proved that the succus is the 
only reliable preparation of hemlock, it is not necessary for 
us to say anything about the tincture, extract, vapor, or com- 
pound pill. Unfortunately, however, it is often difficult to 
obtain an efficient succus, as it keeps ill, and cannot always 
be satisfactorily made. This is no doubt due to the fact of 
the cultivated plant being used, which is quite inert. Dis- 
appointments frequently occur both from this cause and from 
the smallness of the dose often given in accordance with the 
recommendation of the Pharmacopoeia. In order to obtain 
any decisive effect we must give [of some preparations, as 
much as] from half an ounce to 3 or even 4 ounces, as has 
been done by Dr. Harley, remembering that the limit of 
safety is reached when any interference with involuntary 
movement is observed, this being- best indicated bv enfeeble- 
ment of deglutition. 

Children bear conium remarkably well. I have given 
ounce doses to a girl of eight, and the late Dr. Anstie pre- 
scribed even larger quantities to a younger child, without 
the slightest development of physiological symptoms. [On 
account of the uncertainty of the strength of juice, it is best 
to begin with small doses, and carefully increase them until 
some narcotic effect is produced. Death has been caused by 
150 minims of Squibb's fluid extract.] 



COPAIBA. 



229 



The alkaloid conia has been occasionally used by subcuta- 
neous injection, but is objectionable from being very variable 
in strength. When injected pure it »is not only quite inert 
(therapeutically) but very irritating (John Harley), and the 
addition of acetic or hydrochloric acid is necessary to insure 
physiological action. 



For Hypodermic Injection. 



R. Conise 

Acid, acetic, fort. 
Spt. vin. rect. 
Aquae destillat. 



or 



5iij, TTjxij; 

5iijss ; 

t'3J; 

ad f.^ij ; 

Five minims of this solution contain one minim of the alka- 
loid, the dose being y 1 ^ to | of a minim. [The dose of 
Conia is about gr. -g^.] 



12 

14 

4 

64 



80 Gm. 



M. 



COPAIBA— COPAIBA. 

[ The oleo-resin of Copaifera multijuga (Hayne) and of other species of 

Gopaifera, U. S. 

Dose, TtT,xv to 5j (1 to 4 Gm.). 

Officinal Preparations, U. S. 

Oleum Copaibse. Dose, ni,viij-xv (.50 to 1 Gm.). 
Pilulae Copaibae (each contains gr. ivss). 3-5 pills.] 

Local Action. 



Physiological. 
Copaiba locally applied 



seems to act as a 
stimulant to the skin. 



slight 



Therapeutical. 

It has been used in this 
way in certain obstinate af- 
fections of the skin, such as 
psoriasis; and in India it 
seems to have been employed 
with some success in leprosy 
and lupus, bearing as it does 
a considerable analogy to the 
gurjun oil which has lately 
acquired so high a reputation 
in the treatment of the first- 
mentioned disease. Its nau- 
seous smell, however, must 
always be a serious barrier to 
to its use. 



20 



230 



COPAIBA. 



Constitutional Action. 



I. Brain and N^ervous 
System. — No influence is ex- 
erted by copaiba on the brain, 
spinal cord, or nerves. 

II. Heart and Circula- 
tion. — No effect is produced 
on these organs, or on the 
respiration and temperature. 

III. Digestive and Secret- 
ing Organs. — 1. Stomach 
and Intestines — Copaiba fre- 
quently causes most violent 
vomiting and purging. 

2. It has a stimulating ef- 
fect on mucous membranes 
generally, but more especi- 
ally on those of the genito- 
urinary tract, in virtue of 
which, after slight prelimi- 
nary irritation, it checks and 
finally arrests excessive dis- 
charges. 

3. Kidneys — Copaiba, and 
more particularly the resin, 
increases very considerably 
the water of the urine with- 
out specially affecting the 
solid constituents. 

4. Copaiba, by internal 
administration, seems to stim- 
ulate the skin, and occasion- 
ally produces an eruption of 
bright red papules, not un- 
like measles, usually begin- 
ning on the hands, spreading 
over the body, and causing 
much tingling and itching. 



Copaiba is an excellent 
remedy (1) in gonorrhoea, 
where it may be given with 
great effect as long as the 
discharge continues thick 
and puriform. When the 
earliest inflammatory symp- 
toms have been subdued by 
alkalies and diluents, it will 
prove our best remedy, and 
it seems to act neither purely 
locally nor constitutionally, 
but in both ways conjointly, 
being altered in some way in 
the blood, and then exerting 
a topical influence on the 
affected mucous tract. (2) 
It is also of service in chronic 
cystitis, and in the later stages 
of bronchitis, when profuse 
and exhausting- discharges 
have been established from 
the bronchial tubes. (3) 
As a diuretic, the resin has 
been most highly praised by 
Dr. Wilks and Dr. F. Taylor 
in the dropsy of heart disease, 
in ascites, and in some forms 



COPAIBA. 231 

of renal affections. (4) Dr. 
Liveing, more especially, has 
drawn attention to the value 
of copaiba in psoriasis and 
other obstinate skin diseases. 

Absorption and Mode of Elimination. 

Copaiba is very rapidly absorbed into the blood, as indi- 
cated by the communication of its nauseous smell to the 
breath and urine, by which channels it is principally elimi- 
nated. On the addition of nitric acid to the urine of patients 
taking copaiba, a milky appearance is produced by precipi- 
tation of the resin, and this is distinguished from albumen by 
the action of heat, which melts the resin and removes the 
deceptive cloud. 

Peculiarities. Mode of Administration. 

The digestive disturbance occasionally caused by copaiba 
prevents some persons from taking it at all, and the almost 
invincibly nauseous nature of its flavor and odor is a serious 
drawback to its use. Capsules both of sugar and gelatine 
have been devised, which are frequently well borne ; but we 
must remember not only that these are often too large to be 
swallowed with comfort by nervous persons, but that their 
use is apt to be followed by disagreeable eructation. No 
means have been proposed to obviate the measly and irritable 
rash which not unfrequently appears on the skins of patients 
under the influence of copaiba ; but various forms of pre- 
scriptions are in general use, and some of these are mode- 
rately effectual in concealing the offensive flavor of this useful 
drug. 



fy. Copaibse f 5 SS I or 2 

Liquoris potassae f 5 SS I " 2 

Misce, agitando, et adde — 

Mucilaginis acacise f 5ij ; " 8 

Spiritus setheris nitrosi f5 ss 5 " 2 

Tincturae opii n|v ; " 

Aquae menthse pip. ad f ^j ; " 32 

Fiat haustus ter die sumendus. 

For gonorrhoea. 



Gm. 



30 



M. 



232 



2 GOLDTHREAD- 


— DOGWOOD 




R. Copaibse 




fgss; 


or 


16 


Syrupi tolutani 




f^ss ; 


a 


16 


Pulveris acacise 




^ss ; 


a 


16 


Acidi sulphuric! aromat. 


f 5ss ; 


a 


2 


Aquae destillatae 




fSvj; 


a 


192 


S. f 3ss ter in die. 










For gonorrhoea. 










R. Resinse copaibse 




3"j ; 


or 


12 


Alcohol 




f5v; 


tt 


20 


Chloroformi 




f 5j ; 


a 


4 


Mucilaginis acaciae 




f .vj ; 


a 


64 


Aquae 


ad f §xij ; 


u 


384 


S. Capiat senranciam ter 


in d 


ie. 






Formula for copaiba as a 


diuretic. 







Gm. 



M. 



Gm. 



M. 



[COPTIS— GOLDTHREAD. 

Coptis trifolia, U. S. 

Goldthread is an indigenous bitter tonic resembling 
quassia, for which it may be substituted. It may be given 
in substance (gr. x-xxx,or .60 to 2. Gm.), or infusion (5j_Oj) 
(dose, f^j-ij, or 32. to 64. Gm.), or tincture (§j-Oj) (dose, 
i'3j-ij, or 4. to 8. Gm.). It contains berberina, but no tannin 
nor gallic acid, being a simple bitter without astringency.] 



[CORIANDRUM— CORIANDER. 

The fruit of Coriandrum Sativum, U. S. 

Enters into Confectio Sennae, Infusum Gentianoe Com- 
positum, Infusum Sennge, and Tinctura Rhei et Sennoe. 

Uses. 

Coriander seed is aromatic and stomachic (dose, 9j to ^j, 
1.60 to 32. Gm.) ; it is rarely used except in combination.] 



[CORNUS FLORIDA—DOGWOOD. 

The baric of Cornus Florida, U. S. 

Officinal Preparations. 

Deeoetum Cornus Floridae. Dose, f.fij (64. Gm.). 
Extraetum Cornus Florida? Fluidum. Dose, f 3ss 
(2. Gm.). 



CREASOTE — CUBEB. 233 

Dogwood is an indigenous, astringent tonic, and has been 
recommended as an antiperiodic as a substitute for cinchona.] 



CREASOTUM— CREASOTE. 

[A peculiar substance obtained from wood-tar, U. S. 

Officinal Preparations, U. S. 

Aqua Creasoti (n^iijj to fgj). Dose, f5ss-iv (2. to 
16. Gm.). 
Unguentum Creasoti (f 5ss to lard §j).] 

This drug [dose, gtt. i-ij (.06 to .12 Gm.), diluted] is now 
but little used [owing to the difficulty of obtaining it pure, 
the commercial article being largely contaminated with cre- 
sylic or carbolic acid] ; but is a useful remedy in some forms of 
sickness and vomiting, as an inhalation for ozcena and vari- 
ous lung diseases with fetid expectoration, and as a local 
application in toothache. 

The mistura creasoti [Br.], containing try to the ounce, 
is a convenient mode of administration. [The ointment is 
used in scaly eruptions. ,] 



[CRETA— CHALK. 

Native friable carbonate of calcium, U. S. {for preparations, see 

Calcium) . ] 



[CROCUS— SAFFRON. 

The stigmas of Crocus sativa, U. S.] 
Saffron is never used, save as a coloring agent. 



CUBEBA— CUBEB. 

[The unripe fruit of Cubeba officinalis (Miquel), Piper Cubeba 
(Linn.), U. S. 

Dose of the powder, gr. xx to 3ij (1.60 to 8. Gm.). 

Officinal Preparations, U. S. 

Extraetum Cubeb® Fluidum. Dose, fjss-ij (2. 
to 8. Gm.). 

Oleo-Resina Cubeba3 (8 times the strength of the 
powder). Dose, n^x-xxx (.60 to 2. Gm.). 

20* 



234 copper. 

Oleum Cubebae. Dose, gtt. v-xij (.30 to .80 Gm.). 
Tinetura Cubebae. Dose, f 3ss— ij (2. to 8. Gm.). 
Troehisci Cubebae (each contains gtt. j of the oleo- 

resin.).] 

Physiological Action. Therapeutical Action. 

Cubebs also has a stimu- Cubebs is occasionally used 

lating action on mucous mem- in cystitis, but it has long 
branes, and more particularly been known as one of the 
on that of the bladder and most efficient and generally 
urethra. In large doses it prescribed remedies for gon- 
causes considerable gastro- orrhcea, acting best during 
intestinal irritation. the acute stage of the disease. 

It has also been found use- 
ful when given in the form 
of lozenges for the relief of 
relaxed sore-throat. 



CUPRUM— COPPER. 

[Cupri Subaeetas. Impure subacetate of copper, 
U. S. 

Cupri Sulphas. Sulphate of copper, U. S. 

Cuprum. Copper wire, U. S. 

Copper is used in preparing Sp. ^Etheris Nitrosi. 

Officinal Preparation, U. S. 

Cuprum Ammoniatum. Dose, gr. J—J (.015 to .03 
Gm.). 

Poisoning. 

The salts of copper in large doses cause vomiting, pain in 
the bowels, cramps in the lower extremities, a strong cop- 
pery taste, diarrhoea, convulsions, palsy, insensibility, and 
death. Marks of inflammation in the stomach and intestines 
are often noticed after death. When the case has been pro- 
tracted, there is often a green tinge of the lining membrane, 
and a jaundiced appearance of the skin. 

Tests. 

The sulphate in a solid state presents a bright blue color, 
and leaves an astringent metallic impression on the tongue. 



copper. 235 

When in solution the transmission of sulphuretted hydrogen 
affords a brownish-black (sulphuret of copper) precipitate. 
Solution of ammonia precipitates a blue substance, which, on 
further addition of ammonia, becomes dissolved ; but when 
only a small amount of the poison is present, no precipitation 
occurs, a clear violet-colored solution being then at once pre- 
sented. Ferrocyanide of potassium throws down a reddish- 
brown (ferrocyanide of copper) precipitate. A piece of pol- 
ished zinc or iron (as the blade of a table-knife) acquires a 
plating of copper, if placed in a liquid containing the above 
salt. 

The tests for the acetate are the same as the preceding, 
except the last. 

The ammonio-sulphate has a brilliant violet-blue color, 
and ammoniacal odor. Solution of arsenious acid produces a 
fresh apple-green precipitate. 

Antidotes. 

Albumen, ferrocyanide of potassium, followed by prompt 
evacution of the stomach. Vomiting should be promoted by 
copious draughts of warm water, milk, or mucilaginous fluids. 
Sugar was formerly recommended. Albumen and milk form 
an insoluble compound with copper, provided they are in large 
excess. The protosulphuret of iron, and iron filings, have 
also been employed with advantage ; but their action is too 
slow. The hydrated oxide of iron has been successfully ad- 
ministered w r here the arsenite of copper has been taken.] 

Local Actions. 

Physiological. Therapeutical. 

Copper has caustic astrin- In the form of the familiar 
gent properties both in sub- blue-stone, or sulphate of cop- 
stance and in solution. per, it is used as an applica- 
tion to venereal sores, ulcers 
in the throat, granular lids, 
to check exuberant granula- 
tions, etc. ; and in solution it 
is a good lotion for various 
ulcerative surfaces, gleet, etc. 



236 



COPPER. 



Internal Actions and Uses. 



Physiological. 

1 . Brain and Nervous Sys- 
tem Copper probably acts 

in some measure as a nervine 
tonic, but when given in 
larger doses peculiar symp- 
toms set in, not unlike those 
of lead poisoning, and con- 
sisting of headache, neural- 
gic pains, cramp, and even 
paralysis. 

2. Circulation and Respi- 
ration — No special effect. 

3. Secreting Organs 

Copper causes prompt and ef- 
fectual evacuation of the con- 
tents of the stomach, acting 
as a direct emetic. It has an 
astringent influence over the 
stomach and intestines, and 
this, if pushed too far, may 
end in £astro -enteritis. 



Therapeutical. 

1. Copper has been used in 
small doses in chorea, epi- 
lepsy, etc., but with no spe- 
cially marked benefit, and it 
has been recommended lately 
in small doses, as an excellent 
tonic in defective nutrition. 



3. Copper is not so much 
used, however, for an emetic, 
as sulphate of zinc, because, 
if by any chance it be not re- 
jected by vomiting, it is liable 
to cause inflammation of the 
stomach. 

Sulphate of copper is a 
good astringent in advanced 
and obstinate diarrhoea. 



Mode of Elimination. 

Copper is eliminated chiefly by the liver and kidneys, the 
intestinal canal, and the salivary glands. 

Method of Administration. 

As already seen, copper may act as a poison by causing 
inflammation of the stomach and intestines, as well as remote 
nervous symptoms. 

Sulphate of copper is the only salt of the metal used in 
medicine, and may be prescribed as follows : — 



]$. Cupri sulphatis, 

Pulveris opii, aa gr. ss ; or 

Extractum gentianse gr. iij ; 

Misce, fiat pilulse nocte maneque sumenda. 

In a case of obstinate diarrhoea. 



1 03 G-m. 

20 " 



M. 



[As an emetic, sulphate of copper is given in doses of gr. 
ij-v (.12 to .30 Gm.).] 



FOXGLOVE. 231 



[Deeoeta. 

The officinal Decoctions are — 

Decoctum Cetraria? Decoctnm Ha?matoxyli 

" Chimaphila? " Hordei 

" Cinchona? Flavae " Quercus Alba? 

" Cinchona? Rubra? " Sarsaparilla? Comp. 

" Cornus Florida? " Senega? 

" Dulcamara? " Uva? Ursa.] 



DIGITALIS— FOXGLOVE. 

[The leaves of Digitalis purpurea, from plants of the second year' s 

growth, II. S. 

Dose, in substance, gr. ss-ij (.03 to .12 Gm.). 

Officinal Preparations. 

Digitalinum (active principle). Dose, gr. ^L (.001 
Gm.). 

Extraetum Digitalis. Dose, gr. J-J (.01 to .03 
Gm.). 

Extraetum Digitalis Fluidum. Dose, mj-ij (.06 
to .12 Gm.). 

Infusum Digitalis (5y to Oj). Dose, f5ij-iv (8. to 
16. Gm.). 

Tinetura Digitalis (^ij to Oj). Dose, n^v-x (.30 to 
.60 Gm.)]. 

Poisonous Effects. 

Digitalis kills by tetanizing the heart muscle, causing rapid 
and irregular action, followed by arrest of action. The face 
grows pale, the pupils dilate, vomiting and diarrhoea super- 
vene, and death usually occurs by syncope. Cases of poison- 
ing, however, are rare, and most of our knowledge under this 
heading has been derived from experiments on animals. 

Antidotes. 

After evacuation of the stomach and the administration of 
tannin, we must obviate the tendency to death by stimulants, 
and by keeping the patient rigidly to the horizontal posture, 
as syncope is readily excited by suddenly sitting up. 



238 



FOXGLOVE. 



Aconite and atropia have been recommended as physio- 
logical antidotes, but we have as yet no evidence of their 
efficacy. 

Local Action. 



Physiological. 

Digitalis has been said to 
possess sedative properties 
when locally applied, and 
there is no doubt that it is 
rapidly and efficiently ab- 
sorbed by the skin. 



Therapeutical. 

Digatalis has been used as 
a local sedative in cases of 
joint, inflammation ; and the 
application to the legs of 
spongio-piline soaked in a 
strong infusion has been found 
to produce diuresis where 
other remedies have failed. 



Constitutional Action. 



I. Brain arid Spinal Cord. 
. — On the brain no direct ef- 
fect is produced, but the re- 
flex irritability of the spinal 
cord seems to be somewhat 
lessened under the toxic ac- 
tion of the drug. 

Stimulation of some por- 
tions of the vaso-motor and 
pneumogastric nerves seems 
to take place, as we shall ex- 
plain more fully when treat- 
ing of the influence of di<ri- 
talis over the heart. 



I. Although no direct ac- 
tion is produced on the brain 
tissue, it is reasonable to sup- 
pose that some alteration in 
cerebral function may follow 
the alterations in the vascular 
system produced by digitalis, 
and perhaps this may in part 
explain the remarkable re- 
sults obtained by Mr. Jones, 
of Jersey, in the treatment of 
delirium tremens by the use 
of this drug. He found that 
half-ounce doses of the tinc- 
ture quieted the delirium, 
reduced fever, and caused 
sleep. But this treatment 
can hardly be recommended, 
as several sudden deaths have 
been thus produced, and as 
it seems not improbable that 
the absence of toxic effects 
in many cases is due to the 
very partial absorption of the 
remedy. 



FOXGLOVE, 



239 



II. Heart and Circulation. 
— Digitalis exerts a decided- 
ly tonic and strengthening in- 
fluence on the heart, render- 
ing its beats slower and more 
forcible, and lengthening the 
period of systole. This result 
seems to depend partly on a 
direct action on the heart's 
muscle itself, but also in some 
degree on stimulation of the 
cardiac inhibitory fibres of 
the vagus, which thus hold 
more forcibly in check the 
rapid rate of pulsation pro- 
duced by the sympathetic 
nerves. If, however, the ad- 
ministration of the remedy 
be too long continued, ex- 
haustion of the pneumogas- 
tric is apt to follow this over- 
stimulation, and the heart, 
being now handed over to 
the unrestrained power of the 
vaso-motor nerve supply, runs 
riot in excessively rapid and 
feeble contractions. 

The tonic influence of digi- 
talis is attended by well- 
marked rise of arterial ten- 
sion, and this is supposed to 
depend on stimulation of the 
sympathetic centres directly 
supplying the smaller vessels ; 
and at the same time the heart 
is induced to act more power- 
fully, to overcome the in- 
creased resistance in front. 



II. The undoubted effect 
of digitalis in slowing and 
strengthening the action of 

o CD 

the heart, would seem to in- 
dicate its use in certain dis- 
eased conditions of the organ, 
but it is only recently that 
this tonic influence has been 
recognized. In former years 
digitalis was looked upon as 
essentially a cardiac sedative, 
and was used to quiet the tu- 
multuous palpitation of hy- 
pertrophy; but we now know 
that it may be prescribed 
with much greater success 
under the following circum- 
stances : — 

1. In palpitation and irre- 
gular action of the heart, 
whether depending on organic 
disease or not, an important 
indication for its use being in- 
termittence, or the occurrence 
of frequent beats which do not 
reach the pulse. 

2. In mitral disease, where 
the cardiac action is feeble, 
and apparently unable effect- 
ually to propel the blood, 
where lividity and dropsy are 
setting in, the lungs becom- 
ing engorged, and the right 
heart oppressed. 

Here we shall derive the 
most signal service from digi- 
talis given in moderate doses, 
and combined with a little 
iron. Dr. B. Foster ascribes 
some of the good effect of 
digitalis in mitral disease to 
its slowing action, giving 
more time for the auricle to 



240 FOXGLOVE. 



empty itself fully of its con- 
tained blood. 

The contracting effect of 
digitalis on the arterioles 
would naturally suggest its 
use in hemorrhage, and it has 
accordingly been found of 
service both in hoemoptysis 
and menorrhagia, although 
in neither is it so efficacious 
as ergot. 

3. In dilatation of the 
heart, where the weak and 
thin muscle acts feebly and 
irregularly, giving rise to pal- 
pitation and breathlessness, 
and causing temporary bruits 
by unequal and ineffectual 
closure of the mitral and tri- 
cuspid valves. 

4. In aortic disease, when 
compensation has not been 
made complete by hyper- 
trophy. 

In short, we may use digi- 
talis whenever the heart is 
acting feebly and irregularly, 
but by its use we cannot ex- 
pect to spur on a normally 
constituted heart with sound 
muscle to overcome difficul- 
ties in front, and we must 
avoid its regular use in the 
compensatory hypertrophy of 
aortic disease, and in fatty 
degeneration, where its tight- 
ening effect on the smaller 
vessels throws an injuriously- 
increased amount of work on 
the structurally-damaged or- 
gan. 

5. Ringer has drawn atten- 
tion to the beneficial action 



FOXGLOVE. 



241 



III. Respiration and Tem- 
perature On respiration no 

effect is produced, and al- 
though, in a state of health, 
digitalis does not lower the 
body heat, it undoubtedly 
possesses this influence over 
febrile conditions, Wunder- 
lich and others bringing am- 
pie evidence to prove its 
power of reducing tempera- 
ture in pneumonia, enteric 
fever, acute rheumatism, and 
other acute disorders. 

Bing holds that digitalis 
is no trustworthy antipyretic, 
as its action does not begin 
for thirty-six to sixty hours 
(Traube), and as it is uncer- 
tain and disturbs digestion. 



IV. Digestive and Secret- 
ing Organs 1. Stomach 

and Intestines. — From its 
bitter taste, digitalis might 
be credited with some tonic 
properties ; but it is really 
much more likely to disorder 
21 



of the temporary use of digi- 
talis in relieving the distress- 
ing attacks of palpitation so 
often due to hypertrophy of 
the heart. 

6. Clifford Allbutt believes 
it to be the best remedy for 
aneurism, given in increasing 
doses, till the pulse comes 
down to 45, and continued as 
long as possible. 

III. Digitalis has been 
found of great service in those 
cases of bronchitis which are 
so frequently associated with 
a weak and dilated right 
heart, and where stimulation 
of the cardiac muscle leads to 
a better arrangement of cir- 
culation through the lungs. 

For the reduction of tem- 
perature, digitalis is seldom 
used in this country, but in 
Germany its antipyretic vir- 
tues are prized. It seems, 
however, to lower the body 
heat without influencing the 
course of the disease ; and as 
it must be given in large 
doses, which may derange the 
digestive functions even if 
they do not prove directly 
dangerous, there does not 
seem to be any real benefit 
following its employment. 



242 



FOXGLOVE. 



than to increase the appetite, 
by causing vomiting. 

It does not seem to affect 
the intestinal tract in any 
way, save in the later stages 
of poisoning, when diarrhoea 
may supervene. 

2. Kidneys Digitalis in- 
creases, under certain condi- 
tions, the flow of urine with- 
out altering in any essential 
respect the quantity or pro- 
portion of its solid ingredi- 
ents. Its diuretic action de- 
pends partly on the tightening 
effect on the arterioles, rais- 
ing the blood pressure in the 
renal glomeruli, and partly 
on the increased power and 
regularity of the heart, im- 
proving the general condi- 
tion of circulation within the 
kidneys. One curious point 
in this connection is, that di- 
gitalis will seldom produce 
diuresis in healthy persons, 
but always acts best when 
dropsical accumulations have 
to be removed. 

V. Uterus Digitalis, from 

its action on unstriped mus- 
cular fibre, has the property 
of stimulating the uterus to 
contraction. 



2. Digitalis is a good diu- 
retic, more especially in car- 
diac acute and renal dropsy, 
and acts best in combination 
with squill and mercury, as 
in the famous Guy's pill. The 
theory of this action, depend- 
ing on heightened blood pres- 
sure within the Malpighian 
tufts, explains the frequent 
failure of digitalis to augment 
the quantity of the urine in 
chronic kidney disease, where 
the arterial tension is already 
high. 



V. It has, therefore, been 
used to contract the uterus, 
and thus check flooding or 
Menorrhagia, and it may also 
act by restoring its normal 
functions when these are sus- 
pended, as in amenorrhea. 



Cautions, Mode of Administration, etc. 

In prescribing digitalis, we are generally advised to sus- 
pend its use from time to time, lest " accumulation" lead to 
poisonous symptoms ; and experience must have shown us 
that, after its prolonged use, uncomfortable symptoms do 
arise. This may be due to elimination from the kidneys 



BITTERSWEET. 



243 



being prevented in some measure by the contracting influ- 
ence of the drug on the renal arteries. [See Physiological 
Effects, p. 239.] 

As regards the best form for its administration, the freshly 
made infusion is usually preferred. 



R. Tinct. digitalis fl^x ; 

Sp. seth. nit. f gss ; 

Inf. buchu f§j. 
S. Ter in die. 



or 



2 
32 



60 Gin. 



M. 



Recommended by Fothergill in simple cardiac debility 
with scanty flow of urine. 



R. Pulv. digitalis gr. xxx ; 

Ferri sulph. exsio. gr. xv ; 
Pulv. capsici gr. xl ; 

Pil. aloe et myrrhse s;ij. 
In pil. Ix div. Una his in die. 



or 



Gm. 



60 



M. 



Recommended by Fothergill in cardiac debility, gastric 
catarrh, and inactivity of the bowels. 



R. Tinct. ferri cliloridi 


ti\xv: 


or 


1 


Glyeerini 


f3j; 


a 


4 


Infusi digitalis 


f 5ij ; 


t i 


8 


Syrupi limonis 


f5ij; 


a 


8 


Infusi calumbse ad f §j ; 


a 


32 


S. Ter die sumend. 








Cardiac tonic. 









Gm, 



M. 



DULCAMARA—BITTERSWEET. 

[ The young branches of Solanum Dulcamara, U. S. 

Officinal Preparations, U. S. 

Decoetum Dulcamaras (gj to Oj). Dose, fjj-ij 
(16. to 64. Gm.). 

Extractum Dulcamaras (alcoholic). Dose, gr. 
x-xx (.60 to 1.30 Gm.). 

Extractum Dulcamaras Fluidum. Dose, f3ss— ij 
(2. to 8. Gm.). 

Dulcamara is a feeble narcotic, formerly recommended in 
mania, rheumatism, and cutaneous diseases. At present it 
is never used to any great extent in regular practice.] 



244 



ELATERIUM. 



ELATERIUM— ELATERIUM. 



[A substance deposited by the jitice 
Ecbalium agreste 

Elaterium. Dose, gr. ± 
terbuck's elaterium, gr. ^.) 

Elaterin (not officinal). 
Gm.).] 

Physiological Actions. 

Elaterium produces irrita- 
tion of the intestine, ending 
in inflammation where in- 
cautiously pushed, and causes 
the evacuation of large quan- 
tities of watery fluid. It 
purges equally powerfully 
when injected below the skin 
or taken by the mouth, but 
it is stated that solution in 
the bile is necessary to de- 
velop its full action. In 
some of the lower animals, 
peculiar nervous symptoms 
follow its use, and vomiting 
and great depression are lia- 
ble to be produced in the 
human subject even by mode- 
rate doses. [It is probably 
our most efficient cathartic, 
in the treatment of dropsical 
diseases, especially after the 
failure of other remedies.] 



of the fruit of Momordica elaterium, 
(Richard), U. S. 

(.015 Gm.). (Dose of Clut- 
Dose, gr. T \- T \ (.004 to .005 

Therapeutical Effects. 

Elaterium is the most 
powerful hydragogue cathar- 
tic with which we are ac- 
quainted, and as such lias 
been used to withdraw watery 
fluids from the intestines in 
various forms of cardiac dis- 
ease, lightening the labors of 
the heart by lessening the 
volume of the blood, and re- 
lieving the cellular tissue and 
various cavities of dropsical 
accumulations. As, however, 
it is uncertain and very de- 
pressing in its action, it is 
now rarely used, in compari- 
son with compound jalap 
powder, which seems to fulfil 
the same useful indications 
without an equal chance of 
seriously weakening the pa- 
tient. 





[Emplastra. 




The 


officinal Plasters are — 






Emplas 


trum Aconiti Emplastrum Hydrargyri 


a 


Ammoniaci 


it 


Opii 


a 


1 i cum Hy- 


n 


Piois Burgundicre 


a 


Antimonii [drargyro 


a 


" Canadensis 


a 


Arnicse 


t i 


' ' cum Cantliaride 


a 


Assafoetidse 


a 


Plumbi 


a 


Belladonnse 


a 


Resinse 


a 


Ferri 


a 


Saponis.] 


a 


Glalbani Compositum 







ERGOT. 



245 



ERGOTA— ERGOT. 

[The sclerotium of Claviceps purpurea (Tulasne), replacing the grain of 
Secale cereale, U. S. 

Officinal Preparations, U. S. 

Extractum Ergotse Fluidum. Dose, r^x-fjj (.60 
to 4. Gm.). 

Vinum Ergotse (f^ij fid. ext. in Oj). Dose, fjss-ij 
(2. to 8. Gm.). 

(Ergotine — not officinal, is a purified extract. Dose, 
gr. v-x = .30 to .60 Gm.)] 

External Action. 
Ergot has no local action. 



Internal Actions. 



Physiological. 

1. On Nervous System 

No special action on any part 
of the nervous system has 
been proved. [Beyond the 
condition of comparative an- 
aemia of the nerve-centres 
caused by contraction of the 
vessels.] 



2. On Vascular System — 
Ergot slightly depresses the 
action of the heart, and re- 
duces the number of its pul- 
sations, and it is said that the 
arterial tension is at first low- 
ered in some slight degree. 
This effect, however, rapidly 
passes away, and a decided 



21 



Therapeutical. 

1. Dr. Brown-Sequard ad- 
vises the use of ergot in some 
forms of paraplegia, unat- 
tended by irritation, and 
where inflammatory symp- 
toms have subsided, believing 
that it acts well by contract- 
ing the dilated vessels. Dr. 
Crichton Browne has recently 
prescribed ergot with success 
in some forms of chronic 
mania. [It has been used 
in whooping-cough, with as- 
serted good results.] 

2. Ergot is now allowed to 
be by far- the best astringent 
in cases of internal hemor- 
rhage, and more especially 
in menorrhagia, hcemoptysis, 
and epistaxis, the use of the 
liquid extract having quite 
superseded the older treat- 
ment by means of acids, gal- 



246 



ERGOT. 



rise in arterial tension follows 
the contracting influence of 
the drug on the arterioles. 
On examining the web of an 
ergotized frog's foot, we may 
distinctly observe the gradual 
contraction of the smaller 
vessels up to absolute obliter- 
ation of their calibre ; and 
this is believed to be due to 
a primary action of the ergot 
on their muscular walls rather 
than to the intervention of 
the vaso-motor system. Thus 
we observe a direct contrast 
to the action of the nitrite of 
amyl. 



3. Respiration and Tem- 
perature No special action. 

4. Urinary Functions 

Ergot, from its specific action 
on unstriped muscular fibre, 
tends to contract the bladder, 
and, by raising the tension 
in the Malpighian bodies of 
the kidneys, it increases the 
urinary flow. 



lie acid and the like, whilst, 
if a more rapid action is re- 
quired, we may subcuta- 
neously inject ergotine. [It 
has also been injected into 
internal haemorrhoids with 
success.] 

It is also a valuable remedy 
in purpura. Von Langen- 
beck, of Berlin, has advo- 
cated the injection of ergotine 
for the obliteration of aneur- 
ismal sacs, but sufficient evi- 
dence has not yet been brought 
forward of the success of this 
practice ; and it has also been 
advised in the case of old 
varicose veins. The gan- 
grenous form of ergotismus 
is doubtless due to arterial 
contraction cutting off the 
supplies of blood to the ex- 
tremities. [Probably it is 
through this influence upon 
the circulation that it is use- 
ful in diabetes insipidus, as 
first suggested by Dr. Da 
Costa, who also uses it with 
good results in albuminuria.] 



4. Ergot has been used 
successfully, and more espe- 
cially when combined with 
iron, in that most trouble- 
some affection, incontinence 
of urine; but, in my own 
experience, belladonna is 
more deserving of confidence. 
Ergot has been recommended 
as a diuretic. Langenbeck 
has much faith in subcuta- 



ERGOT. 



247 



5. Digestive Organs 

Ergot occasionally causes 
sickness, vomiting, and diar- 
rhoea ; but constipation is 
more likely to follow its use, 
from its contracting influence 
on the intestinal capillaries. 

6. Uterine Functions. — 
Ergot has a remarkable and 
almost selective influence on 
the uterus, contracting its 
muscular walls, promoting 
its functions, and encourag- 
ing the expulsion of its con- 
tents. 



neous injection of ergotine in 
the atony of the bladder and 
enlarged prostate, met with 
in the old. 

5. Ergot has been success- 
fully prescribed in cases of 
diarrhoea and dysentery. 



6. Ergot acts asanecbolic, 
expelling the contents of the 
uterus by causing contraction 
of its muscular walls. It 
must only be used, however, 
where no disproportion ex- 
ists between the child and the 
maternal passages, and where 
we are prepared to render in- 
strumental aid at once, if 
necessary, when the pains 
have been aroused. We must 
also remember that its pro- 
longed use is apt to endanger 
the life of the child by cut- 
ting off its supplies of blood 
through the placenta. 

Ergot is also of service in 
flooding, in reducing the size 
of hypertrophied or subin- 
voluted wounds, and in pro- 
moting the destruction of 
submucous polypi, either by 
cutting off their supply of 
blood, or by squeezing them 
/out of the uterine cavity. It 
is also an excellent remedy 
for amenorrhcea and some 
forms of leucorrhoea. 



248 ERGOT. 

Mode of Administration, Dangers, Cautions. 

In those countries where ergotized rye largely prevails, 
two forms of disease attend its use. 1. The gangrenous 
form of ergotismus, where extensive dry gangrene of the 
nose, face, and extremities supervenes ; and, 2. The spas- 
modic variety, where the victim is afflicted with most violent 
and agonizing spasms. [There is room for the suspicion 
that in those places where ergotism occurs, the general 
hygienic conditions are much more at fault than the ergot 
itself.] The therapeutic use of ergot, however, is of course 
never productive of any such symptoms, and the only incon- 
venience occasionally observed is some digestive derangement, 
with colicky abdominal pain. 

In addition to those named, the three following prepara- 
tions are officinal in the British Pharmacopoeia : — 

Extractum ergotre liquidum. Dose, rr^x ad f'5j (-60 to 4. 
Gm.). This is apt to be uncertain. 

Infusum ergotae [Br.]. Dose, fjj adf^ij (32. to 64. Gm.). 

Tinctura ergotre [Br.]. Dose, n^x ad f'3J (.60 to 4. Gm.). 

The powder is also used in doses of from 20 to 30 grs., 
and many experienced authorities recommend a fresh in- 
fusion made with the powder and swallowed. 

Ergotine may be employed by subcutaneous injection, but 
this process has the drawback of causing a painful, black, 
and unsightly lump at the seat of puncture. 

R.. Extracti ergotae fluidi f 5ij ; or 8 Gm. 

Decocti aloes compositi [Br.] ad f §viij ; " 256 " M. 

Fiat mistura, de qua capiat unci am imam bis in die. 

Useful in amenorrhcea. 

R,. Pulveris ergotse gj ; or 4 Grm. • 

Sacchari giv ; " 16 " 

Aquae bullientis fgiij ; " 96 " M. 

S. Capiat coclilearia duo magna quarta quaque parte liorae 
ad effectum. 

In a case of labor. 

In a case of amenorrhoea from anaemia we may add a 
little ergot to any chalybeate mixture. 



THOROUGHWORT. 249 



[ERIGERON— FLEABANE. 

The leaves and tops of Erigeron heterophyllum and of Erigeron 
Philadelphicum, U. S. 



ERIGERON'CANADENSE— CANADA 
FLEABANE. 

The leaves and tops of Erigeron Canadense, U. S. 

Officinal Preparations, U. S. 

Extraetum Erigerontis Canadensis Fluidum. 

Dose, f'5 ss -j (2. to 4. Gm.). 

Oleum Erigerontis Canadensis. Dose, gtt. v 
(.30 Gm.). 

Is diuretic, tonic, and astringent. It is chiefly used in 
hemorrhage in the form of the oil (dropped on sugar) gtt. 
v— xx, repeated every two or three hours ; or a tincture may 
be employed. An infusion has also been used in dropsy, 
and in genito-urinary affections.^ 



[EUPATORIUM— THOROUGHWORT. 

The tops and leaves of Eupatorium perfoliatum, gathered after flowering 
has commenced, U. S, 

Officinal Preparation, U. S. 

Infusum Eupatorii. Dose, fjj-ij (32. to 64. Gm.). 

Thoroughwort, or Boneset, is a bitter tonic and sudorific, 
and in large doses produces vomiting and purging. The hot 
infusion has been largely given for " colds,'* muscular rheuma- 
tism, and catarrh. The infusion is emetic in doses of a pint. 
Dose of the powder as a tonic, in dyspepsia, gr. xx-xxx 
(1.30 to 2. Gm.).] 



250 



YEAST. 



[Extracta. 

The officinal Extracts are — 



Extr 



actum Aconiti 
Arnicae 

Belladonnse ' 

" Alcoholicum ' 

t( Radicis Fluidum ' 

Buchu Fluidum ' 

Calumbae Fluidum ' 

Cannabis Americans ' 

" Indicse ' 

Chimaphilae Fluidum ' 

Cimicifugse Fluidum ' 

Cinchonas ' 

" Fluidum ' 

Colcliici Aceticum ' 

" Radieis Fluidum ' 

" Seminis Fluidum ' 

Colocynthidis ' 

' ' Compositum ' 

Conii ' 

" Alcoholicum ' 

" Frilctus Fluidum ' 

Cornus Floridae Fluidum ' 

Cubebae Fluidum ' 

Digitalis ' 

" Fluidum * 

Dulcamarae ' 

" Fluidum ' 

Ergotae Fluidum ' 

Erigerontis Canadensis l 

[Fluidum ' 

Gelsemii Fluidum ' 

Gentianse ' 

" Fluidum ' 

Geranii Fluidum ' 

Glycyrrhizae ' 

" Fluidum ' 

Gossypii Radicis Fluidum ' 

Haematoxyli ( 

Hellebori ' 

Hydrastis Fluidum ' 

Hyoscyami i 



Extractum Hyoscyami Alcoholicum 
" " Fluidum 

u Ignatiae 

Ipecaeuanh.se Fluidum 
*Jalapse 
Juglandis 
Krameriae 

' ' Fluidum 
Lupulinae Fluidum 
Matico Fluidum 
Mezerei Fluidum 
Nucis Vomicae 
Opii 

Pareirae Fluidum 
Physostigmatis 
Podophylli 

PruniVirginianae Fluid. 
Qu assise 
Rhei 

" Fluidum 
Rubi Fluidum 
Sabinae Fluidum 
Sarsaparillae Fluidum 

" Compositum Flu. 
Scillae Fluidum 
Senegae 

" Fluidum 
Sennae Fluidum 
Serpentariae Fluidum 
Spigeliae Fluidum 

" et Sennae Fluid. 
Stillingi ae Fluidum 
Stramonii Foliorum 

1 ' Seminis 
Taraxaci 

" Fluidum 
Uvae Ursi Fluidum 
Valerianae 

' ' Fluidum 

Veratri Viridis Fluidum 
Zingiberjs Fluidum.] 



[FERMENTUM— YEAST. 

A peculiar insoluble product of the fermentation of malt liquors, U. S. 

Yeast is tonic, stimulating, slightly nourishing, and laxa- 
tive. It contains alcohol, gluten, carbonic acid, and bitter 



IRON. 251 

extractive from hops, and has been given, in doses of a pint, 
daily in low fevers attended with irritable stomach. It has 
also been used in diabetes and boils. Mixed with flaxseed 
meal or other farinaceous substances, it forms the yeast poul- 
tice, which is much used in gangrenous ulcers.^ 



FERRUM— IRON. 

[Ferri Hypophosphis. Hypophosphite of iron. 
Dose, gr. v-x (.30 to .60 Gm.). 

Ferri Sulphuretum. Protosulphuret of iron pre- 
pared by melting together sublimed sulphur and iron in small 
pieces, U. S. (Used only to make Hydrosulphuric acid.) 

Officinal Preparations, U. S. 

Ferri Chloridum. Dose, gr. v-x (.30 to .60 Gm.). 

Liquor Ferri Chloridi. Dose, n^x (.60 Gm.). 

Tinetura Ferri Chloridi. Dose, ni^x-xl (.60 to 
2.60 Gm.). 

Ferri Citras. Dose, gr. v-xx (.30 to 1.30 Gm.). 

Liquor Ferri Citratis. Dose, n^x-xl (.60 to 2.60 
Gm.). 

Ferri et Ammonii Citras. Dose, gr. v~x (.30 to 
.60 Gm.). 

Ferri et Ammonii Sulphas. Dose, gr. iij-xij (.20 
to .75 Gm.). 

Ferri et Ammonii Tartras. Dose, gr. x-xxx (.60 
to 2. Gm.). 

Ferri et Potassii Tartras. Dose, gr. x-xxx (.60 to 
2. Gm.). 

Ferri et Quiniffi Citras. Dose, gr. v-xv (.30 to 1. 
Gm.). 

Ferri et Stryehnias Citras. Dose, gr. iij-v (.20 to 
.30 Gm.). 

Ferri Ferrocyanidum (Prussian blue). Dose, gr. 
v (.30 Gm.). 

Ferri Laetas. Dose, gr. ij-x (.12 to .60 Gm.). 

Ferri Oxalas. Dose, gr. ij-v (.12 to .30 Gm.). 

Ferri Oxidum Hydratum. Dose, gr. v (.30 Gm.). 
(As an antidote, gr. xx for each grain of arsenious acid 
swallowed.) 

Ferri Phosphas. Dose, gr. v-x (.30 to .60 Gm.). 



252 iron. 

Ferri Pyrophosphas. Dose, gr. ij-vj (.12 to .40 
Gm.). 

Ferri Subcarbonas. Dose, gr. v-xx (.30 to 1.30 
Gm.). 

Emplastrum Ferri. 

Troehisei Ferri Subcarbonatis. (Each gr. v of 
iron.) 

Ferri Sulphas. Dose, gr. i-v (.06 to .30 Gm.). 

Mistura Ferri Composita. Dose, f gss (16. Gm.). 

Ferri Sulphas Exsieeata. Dose, gr. i-ij (.06 to 
.12 Gm.). 

Ferrum Redaetum. Dose, gr. ij-v (.12 to .30 Gm.). 

Pilula Ferri Carbonatis (Vallet's Mass). Dose, gr. 
x-xx (.60 to 1.30 Gm.). 

Pilule Ferri Composite. Dose, 2 to 6 pills. 

Pilula? Ferri Iodidi (each contains gr.j iodide of iron, 
and gr. ^ of reduced iron). 

Syrupus Ferri Iodidi (gr. vij J to f 3j). Dose, n^xx 
-xl (1.30 to 2.60 Gm.). 

Liquor Ferri Nitratis. Dose, n^x-xx (.60 to 1.30 
Gm.). 

Liquor Ferri Subsulphatis (MonsePs Solution). 
Dose, nijj-x (.12 to .60 Gm.). 

Liquor Ferri Tersulphatis (used to prepare hy- 
drated sesquioxide of iron). 

Potassii Ferroeyanidum. Dose, gr. x-xv (.60 to 
1. Gm.). 

Iron is also used in preparing Potassii Bromidum, Am- 
monii Bromidum, and Ferri Bromidum (not officinal). 
Dose, gr. x-xx.] 

Local Effects. 
Physiological. Therapeutical. 

Certain of the stronger In the form of the per- 
preparations of iron are very chloride [chloride], iron is 
astringent, corrugating and one of our most generally 
hardening the tissues by co- used astringents for the ar- 
agulating their albumen, and rest of hemorrhage, as in 
also contracting the smaller epistaxis, leech-bites, in 
bloodvessels. flooding (injected into the 

uterus, as advised by Dr. 

Barnes), or, in fact, in any 



iron. 253 

variety of passive hemor- 
rhage. 

It is also a valuable appli- 
cation to relaxed mucous 
membranes ; thus, in many 
forms of sore throat, equal 
parts of tinct. ferri and gly- 
cerine will act well. It forms 
a good injection for leucor- 
rhcea, and is extensively em- 
ployed as an enema for the 
destruction of thread-worms. 
Velpeau recommended the 
application of a strong so- 
lution of sulphate of iron to 
the inflamed skin in erysipe- 
las, and Ricord considers 
that tartrate of iron has an 
almost specific influence over 
the destructive ulcerative 
process of syphilitic phage- 
dena. 

Internal Actions and Uses. 

Physiological. Therapeutical. 

1. Brain and Nervous 1. Iron is much used as 

System. — Iron has a tonic in- a tonic in all conditions or 
fluence over the nervous sys- nervous exhaustion and de- 
tem, but occasionally, in pie- bility. Thus in neuralgia, 
thoric persons, the stronger which consists in a weakened 
preparations will cause an state of the roots of certain 
uncomfortable sensation of sensory nerves, it is invalu- 
fulness and throbbing in the able. In chorea, which gene- 
head, rally coincides with debility, 
[In combination with bro- and in all cases depending in 
mine, as bromide of iron, it any way on want of nerve 
is a valuable antispasmodic tone, it is a remedy of real 
tonic, and is used by Dr. Da value, as originally pointed 
Costa in chorea.] out by Brown-Sequard and 

confirmed by Hughlings Jack- 
son. Iron does not agree with 
epileptics, increasing the ten- 
22 



254 



IRON. 



2. Circulation and Respi- 
ration. — Iron acts as a tonic 
to the muscular structures of 
the heart, probably by sup- 
plying the stimulus of a 
larger supply of healthy 
blood. It is well known that 
iron not only augments the 
quantity of red coloring mat- 
ter in the red corpuscles of 
the blood, but actually in- 
creases their number, this 
fact being proved by an in- 
genious instrument which 
enables us to calculate the 
proportion of red corpuscles 
which any given specimen of 
blood contains. 

Iron is held to increase the 
plasticity of the blood and to 
increase the red corpuscles by 
passing into and stimulating 
the lymphatic system and en- 
couraging the transformation 
of the lymph globules. Re- 
cent researches have shown 
that no effect of this nature 
is produced on healthy blood, 
but that in anaemia the num- 
ber of red corpuscles is very 
rapidly increased under the 
use of iron as the primary 
effect, without a proportionate 



dency to tits. Gowers, who 
has carefully investigated this 
point, shows that it makes 
many cases worse, has no 
influence on others, but a 
third class, on the border line 
between epilepsy and hyste- 
ria, may even derive benefit 
from the action of iron as a 
nervine tonic. 

2. This increase in the red 
corpuscles of the blood, and, 
as a consequence, in the. ex- 
tent to which these important 
bodies carry out their func- 
tion of bearing oxygen to the 
tissues, and finally converting 
it into ozone, explains further 
the marvellous tonic influence 
of iron. In ancemia, in pro- 
tracted convalescence from 
acute disease, in general 
feebleness or debility, in chlo- 
rosis where it also acts by 
giving increased tone to the 
uterine functions, in struma, 
rickets, m secondary syphilis, 
etc., iron forms the basis of 
every method of treatment. 



IRON. 



255 



3. Here we have another 
explanation of its tonic prop- 
erties. 



rise in the hsemaglobin ; how- 
ever, when this also is second- 
arily augmented, the number 
of globules may even fall. 

3. On Secreting Organs. 
— On the stomach, iron acts 
by bracing up the mucous 
membrane, and improving 
the appetite and digestive 
tone. 

Its astringency tends to This action is utilized in 
cause constipation. the treatment of diarrhoea, 

where some of the more as- 
tringent preparations, as the 
pernitrate [nitrate, U. S.], 
are often of service. 

[But in ordinary tonic 
doses, the tincture of the 
chloride relieves vesical irri- 
tability, strangury, and spas- 
modic stricture; and is much 
used in gleet and chronic 
Bright 7 s disease.^ 

4. On Temperature. — Iron 
raises the temperature partly 
by increasing the waste of 
the tissues, but partly also 
in virtue of its ozonizing 
properties. 

Specific Action. 

Iron has a very marked influence in checking erysipelas, 
which must be called specific. We here use the tincture of 
the perchloride [chloride], and give it in doses of from f3ss 
to f 3j every three or four hours. It is also of service in 
diphtheria ; and Dr. Russell Reynolds has lately brought the 
evidence of over sixty cases to show that in acute rheuma- 
tism, given in large doses, it rapidly diminishes the pain 
and fever. 



Urine. — Iron increases the 
amount of urea given off by 
the urine, and occasionally 
irritates the bladder, causing 
frequency of micturition. 



Mode of Absorption and Elimination. 

The more soluble forms of iron are readily absorbed, and 
become combined as albuminates with the albumen of the 



256 iron. 

blood, whilst the solid preparations must first undergo 
solution in the gastric juice. When they have played their 
part within the organism, they are thrown out principally by 
the feces, to which they impart a blackish color, but also in 
some measure by the pigment of the urine, the skin, hair, 
nails, urine, and by albuminous secretions such as those of 
the bile, by all mucous and serous membranes, and by the 
epithelium, etc. etc. 

Modes of Administration. Drawbacks. 

We have seen that various inconveniences may attend the 
use of iron, such as headache, irritability of bladder, consti- 
pation, nausea, etc., and it further has the disadvantage of 
blackening the tongue and teeth ; but many of these evils 
may be avoided by using the lighter or less astringent prepa- 
rations, such as the citrate of quinine and iron, vinum, sac- 
charated carbonate, or by combining with some aperient, and 
by giving each dose after a meal. 

But if no contraindication exists, there is no doubt that 
the astringent properties of the per-salts of iron stand us in 
good stead, and in particular, no preparation is so useful 
on the whole as the old muriated tincture. In secondary 
syphilis the syrup of the iodide is of service, and children 
will always take steel wine or the saccharated carbonate 
well ; whilst in cases of chlorosis with disordered menstrual 
function we shall find the mist, ferri composita to be \ery 
efficacious in improving the quality of the blood and gently 
stimulating the uterus to resume its neglected duties. The 
sulphate of iron has some influence in aiding the action of 
some purgative salts, as the sulphate of magnesia. The pre- 
parations of iron are so very numerous that no one but a 
student on the very brink of an examination would think of 
burdening his memory with them all ; and we shall only 
refer, therefore, to those which form part of the daily stock- 
in-trade of the practical physician. 

Vinum ferri [Br.] may be given in doses of from f 3j to 
f 5ij ; mistura ferri aromatica [Br.] f 3 j ad f ^ij ; mistura 
ferri composita f ^j ad f ^ij ; ferri carbonas saccharata [Br.] 
gr. v ad 5j ; syrupus ferri iodidi n^x ad f 3J ; ferri et am- 
monioe citras gr. v ad x ; ferri et quinia? citras gr. v ad xx. 
Or in combination — 





FIG — 


MALE FERN, 






R. 


Tincturse ferri chloridi 


ttl*; 


or 






Spiritus chloroformi 


mxv; 


a 


1 




Glycerinae 


f 3ss ; 


a 


2 




Infusi calumbse 


ad f §j ; 


a 


32 


s. 


Ter die sumend. 









257 



65 Gm. 



Chalybeate mixture. 

R. Misturse ferri compositse, 

Decocti aloes compositi [Br.] aa f ; 
Fiat haustus ter die sumendus. 



;SS 



M. 



or 16. Gm. M. 



R. Magnesii sulphatis 


§ij ; 


or 64 


Ferri sulphatis 


gr. xxiv ; 


" 1 


Acidi sulphurici diluti 


mi ; 


" 8 


Infusi calumbse 


ad f §viij ; 


"256 



Gm. 



60 



M. 



S. Capiat cochlearia duo magna omni mane. 
Ferruginous aperient. 

Iron, as a rule, is best taken after a meal, but we must 
warn our patient to avoid the neighborhood of tea, as the 
mixture of these two ingredients forms a species of ink, which 
is both nauseous and unsightly. As the more astringent 
preparations not only stain but injure the teeth, they may 
be conveniently sucked through a glass tube. 



FICUS— FIG. 

[ The dried fruit of Ficus Carica, U. S. 

Figs are slightly laxative, and enter into Confectio Sennae, 
U. S.] 



FILIX MAS— MALE FERN. 

\_The rhizome covered with portions of the stipes of Aspidium Filix mas. 
When used only such portion of the rhizome as has retained its green 
color should be employed, and the stipes, being inert, should be re- 
moved, U. S. 

Officinal Preraration, U. S. 
Oleoresina Filicis. Dose, nrv-xv (.30 to 1. Gm.).] 

Local Action. 

Fern oil has no local action. 

22* 



258 



FENNEL. 



Constitutional Action. 



Physiological. 

The only marked action of 
the male fern is that of killing 
tape-worms. It occasionally 
produces a little nausea and 
diarrhoea, but in most cases 
it can be taken without dis- 
comfort. [Its virtue resides 
in an oleoresin, which is the 
officinal title in the U. S. P., 
but which is termed a fluid 
extract in the Ph. Br. ; it is 
also sometimes spoken of 
simply as the oil of male 
fern.] 



Therapeutical. 

Fern-oil is used in medi- 
cine purely as an anthelmin- 
tic. Its destructive influence 
over all varieties of tcenice 
has been effectually proved 
by a great mass of evidence, 
and one or two doses gene- 
rally succeed in dislodging 
the entire worm. It is essen- 
tial that the draught should 
be taken on an empty sto- 
mach, and, the intestines 
having been first cleared by 
a purgative, we direct our 
patient to fast for a few hours 
before bed-time, when he is 
advised to take a drachm of 
the liquid extract [oleoresin] 
suspended in milk. Or we 
may avail ourselves of the 
following formula, which acts 
well in concealing the nause- 
ous flavor of the drug : — 



or 



6 
16 



Gm. 



$. Oleoresina? filicis f £jss ; 

Mucilaginis tragacanthae f.^ss; 
Syrupi zingiberis f 5Jij ; " 8 

Aquae ad f §iss. " 48 

Misce, fiat haustus nocte vel primo mane sumendus. 



[FCENICULUM— FENNEL. 

The fruit of Fceniculum dulce (De Candolle), U. S. 
Officinal Preparations, U. S. 

Oleum Fcenieuli. Dose, n^v-xv (.30 to 1. Gm.). 
Aqua Fcenieuli (oil ni,xv to Oj). 

Also enters into Tinctura Rhei et Sennae. 
Much used in infusion as an aromatic carminative, for 
flatulent colic in infants.] 



GALBANUM — NUTGALL. 259 

GALBANUM— GALBANUM. 

[The gum-resin of an undetermined plant, U. S. 
Dose, in substance, gr. x-xx (.65 to 1.30 Gm.). 

Officinal Preparations. 

Emplastrum Galbani Compositum (containing 
turpentine, Burgundy pitch, and lead plaster). 

Pilule Galbani Composite (each, galbanum, gr. 
jss ; myrrh, gr. jss ; assafoetida, gr. ss).] 

Also enters into Emplastrum Assafoetidse. 

Galbanum and ammoniacum are substances of no special 
theoretical value [but are ranked as expectorants, anti- 
spasmodics, and stimulants]. 



GALLA—NUTGALL. 

[A morbid excrescence upon Quercus infectoria, U. S. 

Officinal Preparations, U. S. 

Acidum Gallicum. Dose, gr. v-xx (.30 to 1.30 Gm.). 
Glyeeritum Aeidi Galliei (3ij to 3j). 
Tinetura Gallae (^ij to Oj). Dose, f'3j-f5iij (4. to 
12. Gm.). 

Unguentum Gallae (1 to 7 of lard). 
Acidum Tannieum. Dose, gr. j-iv (.06 to .25 Gm.). 
Unguentum Aeidi Tanniei (3ss to gj). 
Glyeeritum Aeidi Tanniei (3ij to f|j). 
Suppositoria Aeidi Tanniei, each gr. v. 
Troehisci Aeidi Tanniei, each gr. j.] 

External Action. 

Physiological. Therapeutical. 

Tannic acid has a powerful Tannic acid is a better 
local astringent action, owing topical astringent than gal- 
partly, no doubt, to its power lie, and may be used to arrest 
of coagulating albumen, and hemorrhage, or diarrhoea, or 
" tanning," in some degree, as an injection for gonorrhoea 
any part to which it may be and leucorrhoea. Combined 
applied. with glycerine, in the form 

of the glycerite of tannin, 
it is very useful as an appli- 



260 



GAMBOGE. 



cation in various forms of 
sore throat, and to arrest the 
discharge in some chronic 
affections of the os uteri, in 
the chronic-weeping stage 
of eczema, in ozcena, and 
chronic otorrhosa. It may 
also soothe and restrain some 
of those irritable coughs 
which depend on chronic 
irritation about the pharynx. 
Galls are used, in the form 
of ointment, as an application 
to haemorrhoids. 



Internal Action. 



Tannic and gallic acids are 
both powerful astringents, 
but as tannic acid is rapidly 
converted in the system into 
gallic acid, it is preferable to 
use the latter. This convic- 
tion is proved by the fact that 
if we take the urine of a pa- 
tient to whom tannic acid has 
been given, we find that it 
will not precipitate gelatine, 
but that it strikes a blackish 
tint with the persalts of iron. 



I£. Acidi gallici 

Glycerinae 

Aquae destillatse 
S. f §j ter die. 



Tannic acid is rarely used 
internally, but gallic acid is 
serviceable in various forms 
of hemorrhage, such as hce- 
moptysis, hcematemesis, and 
menorrhagia ; but in all of 
these it must yield the palm 
to ergot, and it is more espe- 
cially in hemorrhage from 
the kidney that its curative 
action comes into play. It 
has also been used with suc- 
cess to check the excretion 
of albumen in chronic renal 
disease. 



5i; 

f §ss ; 
f ivj ; 



or 



4 

16 

192 



Gm. 



M. 



For hemorrhages. 



GAMBOGIA— GAMBOGE. 

\_A gum-resin derived from Garcinia Morella (Desrousseaux), var. 
pedicellata, U. S. 

Dose, in substance, gr. ij-iij (.12 to .20 Gm.). 

It enters into Pilulae Catharticae Compositse.] 



GAMBOGE. 261 

Local Action. 

Gamboge has no local action, and differs from some other 
remedies of the same class in not exerting its purgative 
effects when applied to a raw surface or injected into the 
cellular tissue. 

Constitutional Action. 

Physiological. Therapeutical. 

On the Digestive and Se- Gamboge is a drastic, hy- 

creting Organs Gamboge dragogue cathartic, formerly 

exerts a good deal of irri- much used where free purga- 
tating effect, acting more tion of watery fluid seemed 
especially on the small intes- to be indicated, as in cardiac 
tine, and producing the dis- dropsy ; but it is not only 
charge of large quantities of disagreeable and irritating, 
watery fluid. If given in but uncertain, and has there- 
sufficient quantity, infiam- fore been in great measure 
mation and ulceration of the superseded by other remedies 
stomach and intestines may on which more dependence 
supervene, and death has can be placed, 
followed the administration 
of a single drachm of the 
powder. It is also usually 
looked upon as a diuretic, 
but no trustworthy evidence 
has been given of its efficacy 
in this direction. 

Absorption, Mode of Elimination, etc. 

In order to insure its full absorption it seems necessary 
that gamboge must be previously dissolved in the bile, as we 
have seen that local application does not produce any purga- 
tive effect. It is, of course, thrown out in great measure by 
the intestines, but the coloring matter is excreted by the 
urine, to which it imparts a bright yellow tinge. 

Mode of Administration, Dose, etc. 

The great objection to the use of gamboge is its uncer- 
tainty, as we can never precisely foresee the cases in which 
it will cause troublesome vomiting and purging. To try and 
obviate this, therefore, as well as to conceal its acrid taste, 



262 YELLOW JASMINE. 

we generally combine it with other drugs ; but on the whole 
I think I am justified in saying that gamboge has no thera- 
peutic advantage which cannot be obtained more conveniently 
and agreeably by the use of other purgative drugs. 

We may most conveniently prescribe the compound pill, 
which contains gamboge, aloes, cinnamon, hard soap, and 
syrup, and of which the dose is from 5 to 15 grains. [The 
compound cathartic pill U. S. P. contains calomel gr. j ; jalap 
gr. j; compound extract of colocynth gr. jj; and gamboge 
gr. \. Dose, 1 to 4 pills.] 



[GAULTHERIA— PARTRIDGE-BERRY. 

The leaves of Gaultheria procumbens, U. S. 

Officinal Preparations, U. S. 
Oleum Gaultheria. Used for flavoring. 

Used in Syrupus Sarsaparillae Compositus, and Trochisci 
Morphiae et Ipecacuanhae. 

Winter-green, or tea-berry, is an aromatic astringent 
tonic, but is chiefly used as a flavoring addition to mixtures.] 



GELSEMIUM— YELLOW JASMINE. 

\The root of Gelsemium sempervirens (Gray's Manual of Botany) , U. S. 

Officinal Preparation, U. S. 

Extractum Gelsemii Fluidum. Dose, gtt. n^v-x 
(.30 to .65 Gm.). 

The tincture is generally kept in the shops, but is not offi- 
cinal. Dose, gtt. x-xl (.60 to 2.60 Gm.).] 

Constitutional Action. 

Physiological. Therapeutical. 

1. Brain and Nervous 1. Gelsemium has been 

System Large doses of gel- prescribed with success in 

semium cause vertigo and neuralgia of the fifth nerve, 

double vision. A paralyzing intercostal and ovarian neu- 

influence is exerted on the ralgia, and myalgia. 

spinal cord, the power of Dr. Spencer Thompson has 

voluntary movement being healed 40 cases of neuralgia 



YELLOW JASMINE. 



263 



finally quite abolished, numb- 



ness 



and 



staggerino; 



being 



preliminary symptoms. Re- 
flex irritability is also sus- 
pended, the pupil dilates, and 
at a later stage the sensory 
columns of the cord are also 
paralyzed, producing com- 
plete anaesthesia (Bartholow). 
The first nerve affected is 
the 6th at its termination, 
causing paralysis of the ex- 
ternal rectus, and later on the 
3d is also attacked. A curi- 
ous point about its action is, 
that when taken internally it 
contracts the pupil, whereas 
on topical application, rapid 
and full dilatation is produced, 
being complete in from 50 to 
70 minutes. One advantage 
which it undoubtedly has 
over atropia, in addition to 
the swiftness of its effects, is, 
that the resulting diminution 
of accommodation for near 
objects is never so well 
marked, and passes away par- 
tially in 10 or 15, and abso- 
lutely in 30 hours. 

Ringer tells us that large 
doses of the alkaloid [Gel- 
semia, of which gr. ^ has 
caused death], at first para- 
lyze, and then excite tetanus, 
which in a short time gives 
way to paralysis. 

2. Heart and Circulation. 
— A slightly weakening effect 
on the heart is noted. [It 
diminishes the pulse-rate by 
lessening the irritability of 
the excito-motor ganglia of 



successfully by gelsemium, 
pointing out, however, that 
its beneficial action is con- 
fined to affections of the tri- 
facial nerve, and more espe- 
cially to the branches supply- 
ing the upper and lower jaw, 
and particularly the latter, 
and that the dose must be full 
n^xx. of the tincture, repeat- 
ed, if necessary, in 1| hour. 



This would indicate a cer- 
tain advantage in ophthal- 
moscopic examinations over 
atropia, which causes much 
annoyance to hard-worked 
people by impairing vision 
for a week or ten days after 
use. 



It has been recommended 
as a remedy for tetanus. 



264 GENTIAN. 

the heart, and the arterial 
pressure by diminishing car- 
diac irritability and vaso- 
motor tonus. 1 ] 

3. Respiration and Tern- 3. Bartholow recommends 

perature The respirations gelsemium in various forms 

become labored, shallow, of convulsive or spasmodic 
and irregular, from dia- cough, and in acute inflam- 
phragmatic paralysis, death mations of the lungs and 
ensuing from asphyxia. The pleura he thinks it may do 
temperature falls, probably good by diminishing the ac- 
in consequence of the pro- tivity of the respiratory func- 
fuse perspiration which it tions. 
induces. 

Dose, etc. 

We may give the tincture every three hours, until droop- 
ing of the eyelid, dilatation of the pupil, and muscular lan- 
guor are noted. [As it is certain that an idiosyncrasy exists 
in regard to this drug with certain patients, it is only safe to 
begin with two or three drop closes, as serious results have been 
reported by Dr. Wharton Sinkler and others from its use.] 



GENTIANA— GENTIAN. 

[ The root of' Gentiana lutea, U. S. 
Officinal Preparations, U. S. 

Extractum Gentianse. Dose, gr. ij-iv (.12 to .25 
Gm.). 

Extractum Gentians Fluidum. Dose, n^x-xxx 
(.65 to 2. Gm.), 

Infusum Gentian® Compositum. Dose, f^j-ij 
(32. to 64. Gm.). 

Tinetura Gentianse Composita. Dose, f3j-iv (4. 
to 16. Gm.). 

Gentian is the type of the simple bitters, and is largely 
employed in cases where a tonic of this kind is indicated. 
As it contains no astringent element, it may readily be ex- 
hibited in combination with iron.] 

Gentian and chiretta may be grouped together, as their 
action is almost precisely similar. They are both light, 

1 [Dr. Ott, Phila. Med. Times, vol. v.] 



CRANESBILL — GLYCERINE. 265 

agreeable tonics, with pleasant, aromatic, bitter flavor, and 
may be used freely in dyspepsia and debility with loss of 
appetite. Gentian has always, however, been much more 
generally employed than chiretta, and this may be partly 
due to the very agreeable compound preparations of the 
former drug. 



[GERANIUM— CRANESBILL. 

The rhizome of Geranium maculatum, U. S. 

Officinal Preparation, U. S. 

Extractum Geranii Fluidum. Dose, f'3ss-j (2. to 
4. Gm.). 

Crowfoot, or cranesbill, is an indigenous astringent tonic, 
containing tannic and gallic acids, and may be used with 
advantage in bowel complaints, and as a styptic. A decoc- 
tion in milk is sometimes given to children.] 



GLYCERINA—GLYCERINE. 

\_A colorless, inodorous, syrupy liquid, of a sweet taste, and having the 
sp. grav. 1.25, U. S. 

Used in preparing the officinal Extracta Fluida, and the 
Glycerita.] 

This useful substance is almost exclusively used exter- 
nally. It moistens and softens the skin, and when properly 
diluted both prevents #nd cures the painful and unsightly 
cracks known as "chaps" on the hands. It is a serviceable 
application, either alone or combined with other drugs, in 
various forms of skin disease. 

It may soothe an irritable cough by moistening the dry- 
ness of the throat, and it is stated to be the most efficient 
means at our command for the prevention of bedsores. In 
addition to this, it forms an excellent vehicle for the solution 
of various drugs, as seen in the five glycerites of the Phar- 
macopoeia, having this additional advantage, that its adhe- 
sive nature enables the active ingredient to remain longer 
than it otherwise would in contact with the affected surface. 
It is also a good solvent of the alkaloids, dissolving them 
freely, and, being decidedly antiseptic, it is now used for the 
preservation of vaccine lymph. 
23 



266 LICORICE. 



Internal Use. 



It was thought at one time that glycerine might prove an 
agreeable and efficient substitute for cod-liver oil ; but this 
has not been confirmed, and glycerine is now seldom used 
internally. It has, however, some gentle laxative proper- 
ties, and has lately been very confidently recommended as a 
remedy for bleeding piles. Very recently, M. Catillon, 
working in Vulpian's laboratory, has found by experiment 
on animals that it increases the appetite, promotes nutrition, 
and lessens the urea. It would therefore seem worthy of 
further trial as an analeptic, although, if the observations of 
MM. Dujardin Beaumetz and Andige are correct, it is a 
drug of active physiological properties not to be rashly em- 
ployed. These gentlemen found that, by subcutaneous in- 
jection, it causes tetanic rigidity, like strychnia, elevation of 
temperature, hematuria, and meningeal congestion. [It has 
been highly commended as a substitute for sugar in the diet 
of diabetic patients.] 



[Glyeerita. 

The officinal Glycerites are — 

Glyceritum Acidi Carbolici Glyceritum Picis Liquidse 

" Acidi Gallici " Sodii Boratis. 

" Acidi Tannici 

Their uniform strength is 5U to the ounce, except glycerite 
of tar, which is 3 s s to foj-] 



GLYCYRRHIZA— LICORICE. 

[ The root of Glycyrrhizce, glabra, U. S. 

Enters into the manufacture of Decoctum Sarsaparillse 
Compositum, Extractum Glycyrrhizse, Extractum Sarsa- 
parillce Fluidum Compositum, Infusum Lini Compositum, 
Pilulse Hydrargyri, and Syrupus Sarsaparillae Compositus. 

Officinal Preparations, U. S. 

Extractum Glyeyrrhiz® Fluidum (for flavoring). 
Extractum Glyeyrrhiz®. Liquorice. 
Mistura Glycyrrhiz® Composita. Brown Mix- 
ture. Dose, fsss-j (16. to 32. Gm.). 
Troehisci Glycyrrhizae et Opii.] 



COTTON. 26? 

This is only used as a flavoring ingredient, and [enters 
into the Pilulse Ferri Iodidi, Tinctura Aloes, Tinctura Rhei 
et Sennae, and Trochisci Cubebae. 

Liquorice is an excellent demulcent, and in the form of 
decoction is used in catarrhal affections and diarrhoea. It 
is largely used as a flavoring ingredient, and is perhaps the 
best adjuvant to quinia, to disguise the bitter taste of that 
drug.] 



[GOSSYPII RADICIS CORTEX—BARK OF 
COTTON ROOT. 

The bark of Gossypium herbaceum, and of other species of 
Gossypium, U. S. 

Officinal Preparation, U. S. 

Extraetum Gossypii Radicis Fluidum. Dose, 

f3ss-j (2. to 4. Gm.). 

This is an efficient oxytocic and . emmenagogue, largely 
employed in the South, in the form of decoction (f^iv to 
Oj) as a parturifacient. A tincture is also used.] 



GOSSYPIUM— COTTON. 

[A filamentous substance separated from the seed of Gossypium 
herbaceum, and of other species of Gossypium, U. S. 

Officinal Preparations, U. S. 

Pyroxylon. Gun Cotton. 

Collodium. Pyroxylon dissolved in ether and alcohol.] 

This useful substance is employed in various inflammatory 
conditions, with the view of excluding air and supplying 
warmth and slight support. Thus in bums, and more es- 
pecially in those of a superficial nature, the immediate appli- 
cation of a thick layer of cotton-wool relieves the smarting 
pain and promotes recovery ; and the same treatment may 
be recommended to a blister after the watery fluid has been 
removed from the bulla. In acute rheumatism, also, the 
patient may derive much relief from the careful and equable 
encircling of his inflamed joints with cotton-wool, secured in 
position by a few turns of flannel bandage. 

It is also believed by some aurists to form the best mate- 
rial for the construction of an artificial membrana tympani. 



268 



COLLODION. 



[COLLODION. 

Collodium cum Cantharide. Blistering Collodion. 
Collodium Flexile. Flexible Collodion.] 

Collodion is used to fulfil two indications : — 



1. To exclude the action 
of the air from inflamed parts, 
and to prevent the patient 
from scratching and irritating 
the surface. 



2. To exert a moderately 
constringent effect, from the 
contraction which follows its 
drying. 



1. For this purpose it is 
used to paint over the pus- 
tules of smallpox, in the hope 
of preventing pitting. Also, 
in herpes zoster and in ery- 
sipelas it may be applied 
with advantage. 

2. Dr. Hare tells us that, 
at the very early or papular 
stage of a boil, we may avert 
subsequent suppuration by 
the application of collodion. 
[In the early stage of a boil 
it may be aborted by touch- 
ing the top with a drop of 
cantharidal collodion.] 

Sir D. Corrigan recom- 
mends sealing up the ex- 
tremity of the prepuce by 
collodion to remedy the 
nocturnal form of inconti- 
nence of urine in children, 
and it may be of service in 
hemorrhage depending on 
capillary oozing, and more 
especially in the troublesome 
bleeding frequently following 
leech-bites. 

Finally, its application 
may facilitate the healing 
process in small cuts and 
wounds, as after the ope- 
ration for harelip, and in 
the troublesome condition 
known as cracked nipples. 
Under all these conditions 



GUAIAC — GUTTA-PERCHA. 269 

the best results may be ob- 
tained by using the flexible 
collodion, in which the com- 
bination with castor oil pre- 
vents the too rapid cracking 
or peeling away of the pro- 
tecting film. 



[GUAIACUM— GUAIAC. 

Guaiaei Lignum. The heart-wood of Guaiacum 
officinale * U. S. 

Guaiaei Resina. A peculiar resin obtained from 
Guaiacum officinale, by spontaneous exudation, by incision, 
by dry heat, or by decoction of the comminuted wood, U. S. 

Officinal Preparations, U. S. 

Tinctura Guaiaei. Dose, f'5j-ij (4. to 8. Gm.). 
Tinetura Guaiaei Ammoniata. Dose, f* 3j— ij (4. 
to 8. Gm.). 

Also enters into Decoctum Sarsaparillse Compositum, 
Syrupus Sarsaparillae Compositus, and Pilulae Antimonii 
Composite. 

Uses. 

Guaiac is alterative, and is largely employed in chronic 
rheumatism, rheumatoid arthritis, and syphilis. The am- 
moniated tincture is the best preparation, and is best given 
in milk.] 



GUTTA-PERCHA— GUTTA-PEKCHA. 

[ The concrete juice of Isonandra gutta (Hooker. Loudon'' s Journal of 
Botany, 1848), U. S. 

Officinal Preparation, U. S. 

Liquor Gutta-Perch® (in chloroform). Used in 
making charta sinapis.] 

Gutta-percha is only adapted for external use, and is of 
service mechanically as a material for splints, being readily 
softened in hot water and moulded to the affected joint or 
limb. It furnishes a cheap and efficient rival to oiled silk, 

23* 



270 



AMERICAN PENNYROYAL, 



and its solution in chloroform forms a good and impervious 
covering in smallpox, erysipelas, and other affections where it 
is of importance to protect the skin from the action of the air. 



HtEMATOXYLON— LOGWOOD. 

[The heart-wood of Hozmatoxylon Campechianum, U. S. 
Officinal Preparations, U. S. 

Decoetum Haematoxyli. Dose, f^ij (64. Gm.). 
Extractum Haematoxyli. Dose, gr. x (.65 Gm.).] 



Physiological Action. 

Loo-wood has astringent 
properties. 



Therapeutical Use. 

It is an agreeable and 
efficient remedy in diarrhoea, 
and is well taken by chil- 
dren. We must remember 
that it imparts its pink color 
to the feces, and to the urine 
should that secretion chance 
to be alkaline. 

[It may be combined for children as in the following 
formulae : — ] 



£• 



S. 



Extracti haematoxyli 
Thicturse catecliu 


gr. x 

f.^ss 


Syrupi 
Aquas carui 
Ter die sumendus. 


f5j; 
ad f §ss 



or 



2 

4 

16 



or 



65 Gm. 



Gm. 



M. 



I£. Pulvera cretse aromatici [Br.] 5J '■> 

Tincturae opii f 5jj ; • 4 

Syrupi zingiberis f §j ; " 32 

Decocti haematoxyli ad f ]|vj ; il 192 

Fiat mistura, cujas sumat unciam unam post singulas dejec 
tiones liquidas. 



M. 



[HE DEOMA— AMERICAN PENNYROYAL. 

The leaves and tops of Hedeoma Pulegioides, U. S. 
Officinal Preparation. 

• Oleum Hedeoma. Dose, gtt. ij-x (.12 to .65 Gm.). 

Hedeoma is a gentle stimulant aromatic used in flatulent 
colic, sick stomach, and in amenorrhcea. In recent suppres- 
sion of the menses, it is a popular domestic remedy, given in 
warm infusion.] 



BLACK HELLEBORE — HOPS. 271 

[HELLEBORUS— BLACK HELLEBORE. 

Root of Helleborus niger, U. S. 

Dose of the powdered root, gr. ij-iij, as an alterative ; or 
gr. x-xx as a purge (.12 to 1.30 Gm.). 

Officinal Preparations, U. S. 

Extraetum Hellebori. Dose, as a purgative, gr. x 
(.65 Gm.). 

Tinetura Hellebori. Dose, as a purgative, f'5y 
(8. Gm.). 

Chiefly interesting on account of its popularity among the 
ancients as a hydragogue cathartic, but as it is harsh and 
uncertain in its action, it is rarely, if ever, used at present, 
except as an ingredient in emmenagogue pills.] 



HORDEUM— BARLEY. 

[ The decorticated seed of Hordeum distichon, U. S. 

Officinal Preparation, U. S. 

Decoetum Hordei (3j to Oj) may be used ad lib.'] 

In the form of decoction, barley is used as a demulcent 
drink. [Malt extract is largely used as nourishment, given 
preferably in milk.] 



HUMULUS— HOPS. 

[ The strobiles of Humulus lupulus, U. S. 

Lupulina. The yellow powder separated from the stro- 
biles of Humulus lupulus, U. S. 

Officinal Preparations, U. S. 

Infusum Humuli (gss to Oj). Dose, ad lib. 

Tinetura Humuli (gijss to Oj). Dose, f^ss-ij (16. 
to 64. Gm.). 

Extraetum Lupulina^ Fluidum (§xvj to Oj). 
Dose, f3ss-ij (2. to 8. Gm.). 

Oleoresin® Lupulina^. Dose, ni,x-f5j (.65 to 4. 
Gm.). 



272 MERCURY. 

Tinetura Lupulinse (gij to Oj). Dose, f^ss-ij (16. 
to 64. Gm.).] 

Hops are tonic and probably narcotic, more especially in 
the form of the old-fashioned hop-pillow. Internally they 
are rarely prescribed. [They are much used as an anodyne 
cataplasm, either alone or with Indian meal. The prepara- 
tions of lupulin are sometimes administered in delirium 
tremens as a sedative tonic] 



HYDRARGYRUM— MERCURY. 

[A silver-white metal, liquid at common temperatures, and having the 
sp. grav. 13.5, U. S. 

Officinal Preparations, U. S. 

I. In the Metallic State. 

Hydrargyrum. 

Emplastrum Ammoniaci cum Hydrargyri. 

Emplastrum Hydrargyri. 

Hydrargyrum cum Creta (mercury 37^ per cent.). 

Dose, gr. v-xxx (.30 to 2. Gm.). 
Pilulee Hydrargyri (mercury 33^- per cent.), 3 gr. pills. 
Unguentum Hydrargyri (mercury 50 per cent.) 

II. Oxidized. 

Hydrargyri Oxidum Rubrum. Used externally. 

Unguentum Hydrarg. Oxidi Rubri (5j-3 v U)* 
Hydrargyri Oxidum Flavum. Used externally. 

Unguentum Hydrarg. Oxidi Flavi (5J— 3 V *J)* 

III. Sulphuretted. 

Hydrargyri Sulphuretum Rubrum. For Fumigating. 

IV. As Protoehloride (subchloride ?). 

Hydrargyri Chloridum Mite. Dose, gr. ss-x (.03 to 
.65 Gm.). 

Pilula3 Antimonii Composite (calomel 16-| per cent.). 

Piluke Cathartics Composite (each pill contains, calo- 
mel, ext. jalap, aa gr. j ; ext. colocynth. comp. gr. 
j^; and gamboge, gr. ^). Dose, 1 to 4. 

V. As Bichloride (proto-ehloride ?, perchloride, 

Br.). 

Hydrargyri Chloridum Corrosivum, gr. T V- to (.004 
to .006 Gm.). 



MERCURY. 273 

Hydrargyri Ammoniatum. Used externally. 
Unguentum Hydrarg. Ammoniati (gr. xl-gj). 

VI. With Iodine. 

Hydrargyri Iodidum Rubrum (biniodide), gr. y 1 ^ (.004 
Gm.). 

Unguentum Hydrargyri Iodidi Rubri (gr. xvj to |j). 
Liquor Arsenici et Hydrargyri Iodidi (Donovan's 

Solution). Dose, Tti^v-x (.30 to .65 Gm.) 
Hydrargyri Iodidum Viride (protiodide). Dose, gr. \ 

(.015 Gm.). 

VII. With Cyanogen. 

Hydrargyri Cyanidum. 

VIII. With Acids. 

Liquor Hydrargyri Nitratis. As a caustic. 

Unguentum Hydrargyri Nitratis (Citrine ointment). 
Hydrargyri Sulphas Flava. Dose, gr. \-\ (Turpeth 

Mineral). As an emetic, gr. ij (.015 to .12 Gm.). 

Poisoning. 

In the metallic state, mercury exercises but slight influence, 
but in a state of vapor it is capable of causing violent symp- 
toms. All the salts of mercury are poisonous ; but the most 
important is corrosive sublimate. 

The symptoms caused by corrosive sublimate resemble 
those produced by arsenic, but, from the salt being more 
soluble, they are more immediate and violent ; there is a 
more marked taste, the evacuations are more frequently 
bloody, and there is a whitened condition of the epithelium 
of the mouth. There are three varieties of poisoning with 
mercury. In the first, the leading symptoms are, violent 
irritation of the alimentary tube ; namely, vomiting, purging, 
pain at the pit of the stomach, and irritation in the throat ; 
metallic, styptic taste, corrosion of the mouth, tongue, and 
palate ; constriction of the throat, and difficulty of swallow- 
ing. Blood evacuated both by vomiting and by stools, sup- 
pression of urine, countenance flushed, tumid, and bloated. 
In the second variety, salivation and sloughing of the mouth 
succeed to the irritation and inflammation. In the third, 
mercurial erethism comes on, and is not preceded by the 
symptoms of local irritation. The first variety arises from 
the more soluble salts of mercury, in large doses ; the second, 



274 MERCURY. 

from the same preparations, but in smaller doses and more 
diluted ; the third, by the more insoluble and refractory 
compounds. 

Morbid Appearances. — These are similar to those attend- 
ant on irritative or corrosive poisoning. There are, fre- 
quently, shrivelling of the tongue, and enlargement of its 
papillae and root. In some cases, red and .black spots in the 
interior of the heart. Corrosion, ulceration, and disorgani- 
zation of the mucous coat of the stomach and intestines. An 
inflamed condition of the urinary organs is also frequently 
observed. 

Tests. 

Corrosive sublimate in a solid state is sublimed when 
heated in a test-tube ; and the acrimonious fumes speedily 
condense into a crystalline, semi-transparent mass. Placed 
in a test-tube, and lime-water, potassa, or soda, added in 
solution, a yellow (peroxide of mercury) precipitate is thrown 
down. 

In solution, ammonia throws down a white (ammonio- 
chloride of mercury) precipitate. Solution of proto-chloride 
of tin affords a precipitate (calomel), which, at first, is white, 
but acquires a leaden color on adding more of the test ; when 
this precipitate (after being well agitated) is dried, minute 
globules of quicksilver may be detected. Transmission of 
sulphuretted hydrogen produces a (sulphur et of mercury) 
precipitate, which at first is leaden colored, then black. 
Solution of iodide of potassium affords an intensely brilliant 
scarlet (biniodide of mercury) precipitate, which dissolves in 
an excess of the test. Corrosive sublimate may be reduced 
to the metallic state through galvanic influence, applied as 
follows : A drop of the suspected fluid being laid on a piece 
of polished gold, and both it and the gold touched at the 
same instant by a point of iron (as a thick needle, or the end 
of a penknife), a small silvery coating of mercury soon be- 
comes apparent on the gold. Being freely soluble in sul- 
phuric ether, addition of this fluid is of much service when 
the poison is found mingled with organic or other matters. 

The cyanide, when heated in a tube, evolves cyanogen 
gas, which will burn with a rose-red flame, with a blue halo. 

Calomel is sublimed by heat. When treated with potassa, 
or lime-water, it assumes a black appearance, mercurous 
oxide being separated. 



MERCURY. 275 

On cautious application of heat, the biniodide sublimes in 
red-colored crystals, which soon change to yellow, and sub- 
sequently to a dusky hue. On exposure to a sufficient degree 
of heat, iodine fumes are disengaged. When mixed with 
potassa (equal weights) and heated in a test-tube, decompo- 
sition occurs ; metallic mercury being sublimed, and iodide of 
potassium deposited in the tube. 

When red precipitate is exposed to heat in a test-tube, 
metallic mercury is sublimed, with the evolution of oxygen. 

If the persulphate be treated in the same manner as the 
foregoing, sublimation of the mercury takes place, and sul- 
phurous acid gas is evolved. 

Antidotes. 

Acute poisoning produced by corrosive sublimate requires 
albumen (white of eggs, blood, or flour and water) and de- 
mulcents. Milk may be freely drunk, and vomiting encour- 
aged. Gold-leaf and iron-filings form a chemical antidote, 
decomposing the chloride and depositing the mercury. It 
has been stated that the hydrated proto-sulphuret of iron, if 
taken immediately, completely destroys the poisonous pro- 
perties of the corrosive sublimate.] 

Local Actions. 

Physiological. Therapeutical. 

One preparation, the acid The acid nitrate is used as 

nitrate, is a very powerful an application in lupoid ul- 

caustic, in virtue of its free cerations, and in ulcerations 

nitric acid. about the os and cervix uteri. 

Other preparations are oc- Calomel in lime-water 

casionally used externally for [5j to Oj] forms the familiar 

skin diseases, syphilitic ulcer- black-wash which is of great 

ations, etc., and in virtue of service in venereal ulcera- 

the destructive power which tions, either primary or secon- 

they all (but more especially dary ; and the same salt, in 

corrosive sublimate) exert the form of powder, may be 

over the lowest forms of ani- dusted on condylomata or 

mal and vegetable life. Mer- corneal ulcerations with ad- 

cury, being readily absorbed vantage. Corrosive subli- 

by the skin, is frequently in- mate, in the form of lotion, 



276 MERCURY. 

troduced into the system by often checks troublesome ul- 
this channel. cerations of the throat : and 

both this and the various 
forms of mercurial ointment 
are almost infallible reme- 
dies for pediculi or for favus, 
tinea tonsurans, and other 
skin diseases which are known 
to depend on the presence of 
minute vegetable growths. 
We must remember, how- 
ever, that dangerous symp- 
toms, and even death, have 
occasionally been caused by 
the absorption of the mineral 
wiien thus applied. 

Many chronic skin dis- 
eases may be well treated 
by citrine ointment. Goitre 
frequently yields in India to 
the inunction of the binio- 
dide, and Mr. Marshall has 
highly recommended the 
oleate of mercury as an ap- 
plication to various joint af- 
fections. 

The external application 
of mercury, by the calomel 
vapor bath, or blue ointment, 
having for its object the pro- 
duction of constitutional 
effects, will be considered 
further on. 

Internal Actions and Uses. 

1. Brain and Nervous Sys- 1. Mercury has been found 

tern Mercury, pushed up to of most signal service in some 

the development of poisonous forms of advanced syphilitic 
symptoms, produces a curious disease affecting the brain. 
condition of nervous debility 
and tremors, which is occa- 
sionally met with in work- 



MERCURY. 



277 



men who have been freely 
exposed to its fumes in silver- 



in or glass . 



2. Circulation and Respi- 
ration One form of mer- 
cury, the perchloride, or cor- 
rosive sublimate, acts as a 
cardiac poison, distinctly low- 
ering the action of the heart, 
but the other preparations 
have no such influence. Mer- 
cury causes ansemia by de- 
stroying the red corpuscles of 
the blood. It has long been 
observed that they become 
spheroidal and of deeper hue, 
have less cohesion, and finally 
dissolve. The blood becomes 
more fluid, and the fibrine 
less coagulable. [But in mi- 
nute doses, gr. T J^ to T ^, 
given thrice daily for a length 
of time, corrosive sublimate 
acts as a tonic and increases 
the number of the red-blood 
corpuscles, particularly in sy- 
philitic ancemia.~\ 

3. Secreting Organs — Sto- 
mach, and Intestines Mer- 
curial preparations, and more 
especially calomel, act as 
purgatives, causing repeated 
grayish or greenish evacua- 
tions ; the duodenum being 
the portion of the gut pri- 
marily acted upon. The ac- 
tion of mercury on the liver 
has provoked a good deal of 
controversy ; and, whereas it 
was formerly held that the 
biliary secretion was directly 
stimulated, the experiments 
of Bennett and the Edinburgh 

24 



2. Mercury acts well in 
some forms of bronchitis by 
removing congestive oedema 
of the mucous membrane, 
and promoting the absorption 
of exudations and deposits. 



3. In that form of vomiting 
common in children, where 
the stomach rejects every- 
thing suddenly and violently, 
^ gr. of hyd. cum creta or ^ 
gr. of calomel every hour will 
often cure, as Ringer has 
shown. Small doses of the 
perchloride are also useful in 
dysenteric diarrhoea. 

Calomel and blue pill are 
frequently used as adjuncts to 
other purgative drugs. 

Clinical evidence has most 
distinctly proved, not only 
that the well-known symp- 



278 



MERCURY. 



Committee seem to show that, 
on the contrary, the flow of 
bile is • actually checked or 
diminished by calomel. Two 
obvious fallacies underlie 
these experiments — the first 
being that the dogs, kept for 
considerable periods with bili- 
ary fistula, were so affected 
not only by the shock of the 
operation, but by the result- 
ing inconvenience, general 
discomfort, and gradual starv- 
ation, that secretion must of 
necessity have been in great 
measure suspended; and, sec- 
ondly, it is well known that 
a remedy which has no effect 
on a healthy organ may pow- 
erfully modify its condition 
when in a state of congestion 
or functional derangement. 

Kidneys Mercury, and 

more especially blue pill, has 
the power of promoting the 
action of diuretics. 

Saliva Mercury is well 

known to stimulate the action 
of the salivary glands, large 
quantities of their secretion 
being poured out when the 
drug is pushed far enough. 
The fluid, at first thick and 
containing much albumen, 
subsequently becomes thin 
and watery. 

Skin Inunction of ung. 

hydrargyri is apt to bring out 
a crop of irritable pimples, 
and one of the symptoms of 
mercurial poisoning is an ec- 
zematous eruption. 



toms of biliousness may be 
most effectively removed by 
the old-fashioned blue pill 
and black draught, but that 
an increase of bile may also 
be thus produced in the mo- 
tions. This has been ex- 
plained by the irritating in- 
fluence of the mercury on the 
duodenum, and the conse- 
quent sweeping away of the 
secreted bile, which, under 
ordinary circumstances, is 
well known to undergo reab- 
sorption from the intestines. 

Mercury has been supposed 
also to act by stimulating the 
gall-bladder to contract. 



Thus, in the form of Guy's 
pill, containing blue pill, 
squill, and digitalis, we ob- 
tain a most marked diuretic 
effect. 

The old-fashioned notion is 
now happily exploded, that 
we must measure the efficacy 
of our mercurial treatment by 
the amount of salivation. 



Ringer praises an ointment 
of calomel 3j> to spermaceti 
^j, in pruritus and pityriasis 
of the scalp, and mercurial 
ointments generally are ex- 
cellent stimulants in many 
chronic skin affections. 



MERCURY. 2*79 

Mercury is supposed to Mercury was accordingly 
stimulate absorption by ren- invariably given, in former 
dering effused fibrine less co- days, in all cases where any 
hesive, by promoting its dis- effusion of fibrine was sup- 
integration, and by retarding posed to have taken place 

such as th/ 

pneumonia 



cell-growth'. such as thje second stage of 



Specific Action. 

Mercury may be said to act as a specific, or at least as a 
true vital antidote, in syphilis, and more especially in the 
primary and secondary stages of that insidious malady. 
When we are satisfied that we have to deal with an infect- 
ing sore, the sooner we begin our mercurial treatment the 
better ; and it is well to push it in small doses for a consider- 
able time, until the gums are slightly affected. For this pur- 
pose moderate doses of blue pill and opium are perhaps the 
most effectual ; but we may also derive much benefit now 
and then from rubbing in 3-ss to 5j °f td Lie ointment, night 
and morning. The whole train, also, of secondary eruptions 
of the skin, sore throat, condylomata, iritis, etc., must also 
be subjected to mercurial treatment, and the calomel vapor 
bath and the bichloride of mercury will here do us good 
service. 

It is doubtful whether, by the most careful and scientific 
treatment of a primary sore, we can altogether prevent the 
development of secondary symptoms ; but if we cannot do 
this we can at least postpone them, and render them less se- 
vere, and also lessen the probability of tertiary mischief. In 
order to get the most satisfactory results, we must continue 
a careful administration of mercury for many months, and if 
this be done, there seems no doubt that syphilis can be readily 
cured, or finally be eradicated from the system. 

In the congenital syphilis -'of young children, the local ap- 
plication of a little blue ointment, either rubbed into the skin 
or smeared over a bit of flannel wound round the waist, is 
eminently satisfactory in its results. 

Mercury was formerly believed to have a specific influence 
in checking the inflammations of serous membranes, and was 
consequently invariably used in peritonitis, pericarditis, and 
pleurisy ; but faith in this conviction has been a good deal 
shaken of late, and the conventional calomel and opium does 
not so often appear in prescriptions as formerly. 



280 MERCURY. 

On the continent much importance is attached to consider- 
able doses of calomel in the early stages of typhoid fever, but 
statistics do not seem to prove any decided advantage as ac- 
cruing from this mode of treatment. 

Drawbacks, Cautions, etc. 

It is important to be familiar with the signs which indi- 
cate when the mercurial treatment has been carried far 
enough. The gums generally give the first token in a deli- 
cate red line running along their margin, followed by pulpy 
thickening of the interdental portions, and finally retraction 
from the teeth. To this succeed [a metallic taste in the 
mouth], an increased flow of saliva and a peculiar fetor of 
breath, and we generally find that the very slightest " touch- 
ing" of the gums is sufficient to show that the physiological 
effect of the mineral has been attained. 

[It should be remembered that salivation comes on rather 
slowly and sometimes appears a day or two after the ad- 
ministration of the mercurial has been suspended ; showing 
that the system may be fully influenced by the remedy for at 
least twenty-four hours before its specific action on the mouth 
is apparent.] 

Whilst a patient is undergoing a mercurial course, we must 
keep up his constitution well with good diet, iron, and per- 
haps a little stimulant; for experience shows that mercury 
far more speedily exerts its debilitating influence on weak 
persons or those who are enfeebled by fasting. 

We must, therefore, beware of its use in consumptive or 
strumous persons, or in those suffering from Bright's disease 
or diabetes, and recollect that idiosyncrasy may here play an 
important part, and that some persons are much more readily 
salivated than others, without known cause. 

Children, more especially those under the age of two years, 
are rarely if ever salivated, and only show the influence of 
the drug by peculiar greenish stools ; but we must beware of 
using it in them too freely, as Mr. Hutchinson has traced a 
peculiar malformation of the teeth to the incautious use of 
gray and other so-called " teething" powders in early life. 
[But where salivation does occur in children it is apt to be 
uncontrollable, and to be followed by destructive ulceration, 
or gangrene of the mouth and lips, with ugly cicatrices.] 



MERCURY. 281 

Mode of Elimination, etc. 

Mercury is eliminated principally by the urine, but also 
in smaller degree by the saliva and the biliary and intestinal 
secretions. 

Modes of Administration, Dose, etc. 

In the treatment of syphilis, mercury may be given by 
inunction, in which from $s,s to 5j of blue ointment is rubbed 
into the skin once or twice a day, varying the place of appli- 
cation so as to avoid that cutaneous irritation which may 
otherwise result. This method, although very effectual, is 
dirty, and rather liable to cause excessive salivation. 

The oleate of mercury made by dissolving the oxide in 
oleic acid, and varying according to strength from a clear 
solution to a resin-like ointment, is a very clean way of using 
the drug externally, and, in addition to its value in syphilis, 
may be employed in articular inflammation, simple syno- 
vitis, threatening abscess, orchitis, sycosis, etc. (Marshall.) 

Fumigation is also extensively employed, but it is only 
of real service in the cutaneous affections dependent on 
secondary syphilis, where the actual deposition of the vapor- 
ized calomel on the skin produces a beneficial local influence. 
Twenty grains of calomel are used at each sitting, and are 
diffused along with watery vapor by a spirit lamp, and 
brought in contact with the patient, as he sits covered with 
a blanket, on a perforated chair, over the fumigating appa- 
ratus. 

Corrosive sublimate has been used by subcutaneous injec- 
tion, but in this way it creates great local irritation, hard, 
black, painful lumps, often running into abscess, being pro- 
duced at the site of puncture, and although much ingenuity 
has been expended on the search for a harmless solution, no 
success has yet attended these efforts. This, however, 
matters the less, because no reliable evidence has been offered 
to show any advantage in this plan over others, and it is un- 
doubtedly much better to administer it by the mouth, when 
it is specially useful in chronic skin and throat affections. 
Some authorities prefer to give it alone, whereas others advise 
a combination with potassic iodide, thus : — ■ 

24* 



282 



MERCURY. 



R. Hydrarg. chlor. corrosiv 
Potassii iodidi 
Decocti cinchonas 



S. 
B. 



f Jj ter die post cibum. 



gr. ss 

^ss; 

f§viij 



or 



or 



2 
256 



03 Gm. 



12 Gm. 



M. 



Hydrarg. chlor. corrosiv. gr. ij 

Acidi muriatici diluti i'5ij ; " 8 

Mellis depurati f |j ; " 32 

Aquae destillatse adffx; " 320 

An excellent gargle for syphilitic throat ulceration. 



M. 



Opinions vary considerably regarding the best form of 
mercury for internal administration in the treatment of sy- 
philis. Mr. Hutchinson prefers hydrarg. cum creta in doses 
of from gr. iij to gr. v two or three times a day. Ricord, on 
the other hand, advises gr. j — iij of the green iodide [but it is 
ordinarily given in much smaller doses to begin with], whilst 
others are content to employ the pil. hydrarg. in gr. j-iij 
doses in pill, keeping its purgative properties in check by a 
little opium. 



R 



i.i ; 

i . 

4 > 
S. 



or 



12 Gm. 
015 " 



Pil. hydrargyri gr. 

Pulveris opii gr. 

Confectionis rosae q. 

Ut fiat pilula quarta quaque hora sumenda. 

[The following is a good formula for the protiodide :- 

K.. Hydrarg. iodidi viridis 

Extract, lactucarii aa gr. xlv 

Extract, opii gr. xv ; 

Confectionis rosse 3jss ; 

In pil. no. lx dividenda. 
S. Dose, 1 to 3 pills a day.] 



M. 



or 



Gm. 



M. 



For purgative purposes the blue pill is generally pre- 
scribed in 5-grain doses, taken overnight, and aided by some 
fluid aperient in the morning. 



H- Hydrarg. chlor. mitts gr. xij ; 

Mannas gr. vj . 

Pulveris tragacanthae comp. [Br.] gr. vj ; 
Divide in pilulas sex. Capiat duas pro re nata. 

A good purgative formula. 



or 



80 Gm. 
40 " 
40 " M. 



As a diuretic the following is the useful old combination, 
sometimes known as the 'Guy's,' and sometimes as 'Baillie's 
Pill :'— 



R. Pilulae hydrargyri gr. iij ; 

Pulveris scillae gr. jss 

Pulveris digitalis gr. ss ; 

Fiat pilula bis terve die sumenda. 



or 



120 Gm. 
ilO " 
03 " 



M. 



HYDRASTIS. 283 

[Unguentum hydrargyri nitratis (citrine ointment), is much 
used as a stimulant and alterative application in chronic 
skin diseases and ophthalmia. It generally requires to be 
diluted with lard. 

The decoction of Zittmann may be used with great ad- 
vantage as a gentle diaphoretic and alterative in secondary 
syphilis, -either alone or as an adjuvant to mercurials. It 
has been also used with advantage in scrofulous conditions of 
the system, in chronic rheumatism, in skin diseases, and 
obstinate ulcerative affections. The dose is one wine-glassful 
of each strength several times daily. The formula of the 
Prussian Pharmacopoeia is as follows : — 

Decoctum Zitmanni fortius Take of sarsaparilla root 

cut 100 parts ; digest in water 2600 parts for 24 hours ; and 
add, inclosed in a linen bag, powdered sugar and alum, each 6 
parts, calomel 4 parts, and cinnabar 1 part ; then heat in a 
covered vessel placed in a steam-bath for three hours, stirring 
frequently, and, near the end of the boiling, add anise and 
fennel, bruised, each 4 parts, senna, cut 12 parts, and licorice- 
root, cut 12 parts. Express, strain, set aside for some time 
and decant to obtain 2500 parts of clear liquid ; 2500 
grammes of this are to be divided into 8 parts. 

Decoctum Zittmanni mitius. — Take the residue left from 
the preceding and 50 parts of sarsaparilla ; heat with water 
2600 parts, for three hours, in a covered vessel placed on a 
steam-bath, stirring frequently, and when near the end of 
the boiling, add lemon-peel, cinnamon, cassia, cardamom, and 
licorice-root, each, cut and bruised, 3 parts. Express and 
operate as before, to obtain 2500 parts. 1 

Mercury was detected by Wiggers in this decoction in 
very small proportion. It should not be prepared in metal- 
lic vessels lest the mercurial in solution should be decom- 
posed.] 



[HYDRASTIS—HYDRASTIS. 

The root of Hydrastis Canadensis, U. S. 
Officinal Preparation, U. S. 

Extractum Hydrastis Fluidum. Dose, f 3ij-iv 
(8. to 16. Gin.). 

1 [The National Dispensatory, Stille and Maisch, Philadelphia, 
1879, p. 497.] 



284 HENBANE. 

Hydrastis is an indigenous bitter tonic, containing the al- 
kaloids berberina and hydrastia, and is said to have decided 
diuretic properties. A decoction has been used as an injec- 
tion in gonorrhoea. Its exact therapeutic place among reme- 
dies does not appear to be well defined.] 



HYOSCYAMUS— HENBANE. 

[Hyoscyami Folia. The leaves of Hyoscyamus 
niger, U. S. 

Hyoscyami Semen, The seed of Hyoscyamus 

niger, U. S. 

Officinal Preparations, U. S. 

Extractum Hyoscyami (from the juice). Dose, gr: 
i-iij (.06 to .20 Gm.). 

Extractum Hyoscyami Alcoholieum (dried 
leaves). Dose, gr. i-iij (.00 to .20 Gm.). 

Extractum Hyoscyami Pluidum (leaves). Dose, 
ntv (.30 Gm.). 

Tinctura Hyoscyami (dried leaves, gij to Oj). Dose, 
f^ss-ij (2. to 8. Gm.). 

Hyoscyamus is, like belladonna, a hypnotic and mydriatic, 
and owns the same antidotes.] 

The remarks made with reference to stramonium are 
equally applicable to hyoscyamus, which also contains an 
alkaloid, hyoscyamia, probably identical with atropia. The 
main point of difference, then, from belladonna, is the supe- 
rior narcotic powers of hyoscyamus, which have been espe- 
cially prized and developed in lunacy practice. It is also a 
favorite remedy in painful and irritable affections of the 
bladder, where it seems to exert a marked soothing influence, 
and it is an excellent addition to cough mixtures. 

I£. Extracti belladonnae . gr. iij; or 120 (1m. 

Camphorse gr. xij ; " 80 " 

Extracti hyoscyami gr. xv ; " l| 

Misce, fiant pilulse sex, quarum sum at imam hora decu- 
bitus. 

Narcotic for nervous insomnia. 



HENBANE. 285 

fy . Tincturae hyoscyami TT\xxx ; or 2 Gm. 

Potassii carbonatis gr. x ; " 65 

Syrupi papaveris [Br.] f 5ij ; " 8 

Aquae camphorae ad f t fjss ; " 48 

Misce, fiat haustus liora somni sumendus. 

Narcotic. 

R. Vini ipecacuanha? f 5ij ; or 8 Gin. 

Ext. hyoscyami fluid. f 5j ■ ; "i 4 

Tincturse scillse f §ss ; " 16 

Syrupi tolutani f §j ; " 32 

Aquae carui ad f |vj ; " 192 

Misce. Capiat semunciam ter quaterve in die. 

Cough mixture. 

Dr. Robert Lawson, late of the West Riding Asylum, has 
recently made a large variety of very interesting physiologi- 
cal and therapeutical observations on the actions and uses of 
Hyoscyamia, the alkaloid of hyoscyamus. He has found 
that it produces " a subdued form of mania, accompanied by 
almost complete paralysis of the voluntary muscles, and end- 
ing in quiet and refreshing sleep ;" and he thinks that this 
might advantageously be substituted for opium in many forms 
of extreme excitement occurring among the insane. He has 
derived great benefit from the drug in " the treatment of 
recurrent, acute, and subacute mania, and the monomania of 
suspicion," and recommends the following formula: — 



R. Hyoscyamise 


gr- J ; 


or 




06 Gm. 


Sp. setheris [Br.] 1 


rriviij ; 


a 




50 " 


Alcoholis 


r^xxiv ; 


a 


1 


60 " 


Aquae fontis 


ad f §j ; 


n 


32 


a 


Misce, ut fiat haustus. 











Ringer records a very interesting case of acute mania in 
which gr. i of hyoscyamia quieted the patient and produced 
sleep, the first dose causing deep flushing of the face and 
hands, with quickening of the pulse. He has found it useless 
in delirium tremens. Mr. Clifford Gill, of the York Asy- 
lum, has made many observations on the drug, finding 
that physiologically it causes loquacious rambling, hallucina- 
tion of sight and hearing, drowsiness, hypermetropia, dry- 
ness of mouth, and deficient co-ordination of lower limbs. 
In violent mania it acts well, but as some persons are intole- 
rant of its action, and death has been caused by syncope, we 

1 [A solution of ether, ten parts, in rectified spirit, twenty 
parts.] 



286 IGNATIA — INFUSIONS. 

must proceed cautiously and begin with small doses (gr. ^~ 
§.). The pure alkaloid is quite expensive, but an efficacious 
extract containing the amorphous salt is made by Mercks ; 
and Gill recommends a solution of gr. ij to the £j of ether and 
alcohol, freshly prepared ; as it soon deteriorates, it must be 
kept from the light. It has also been used with some success 
in chorea. 



[ICHTHYOCOLLA— ISINGLASS. 

The swimming bladder of Acipenser Huso, and of other fishes, U. S. 

Isinglass is only used in medicine as an article of diet for 
the sick, and as the basis of court-plaster C\ 



[IGNATIA— IGNATIA. 

The seed of Strychnos Ignatia, U. S. 

Officinal Preparation, U. S. 

Extraetum Ignatia. Dose, gr. J--J (.015 to .03 
Gm.). 

Is used for the same purpose as Nux Vomica, but the 
extract, containing more strychnia, is a somewhat stronger 
preparation.] 



[Infusa. 

The officinal Infusions are — 

Infusum Angustura? Infusum Lini Compositum 

" Anthemidis " Pareirse 

" Buchu " Picis Liquid* 

" Calumba? " Pruni Virginiana? 

" Capsici " Quassia? ' 

" Caryophylli " Rhei 

" Cascarilla? " Rosa? Compositum 

" Catechu Compositum " Sal viae 

" Cinchona? Flava? " Senna? 

" Cinchona? Rubra? " Serpentaria? 

" Digitalis " Spigelia? 

" Eupatorii " Tabaci 

" G-entiana? Compositum " Taraxaci 

" Humuli " Valeriana? 

" Juniperi " Zingiberis.] 
" Krameria? 



IODINE. 287 

IODINIUM— IODINE. 

[ A bluish-gray non-metallic element obtained principally from the ashes of 
sea-weeds. It melts and rises in purple vapor when heated. 

Officinal Preparations, U. S. 

Tinetura Iodinii (Iodine £j to Oj). For external use. 

Tinetura Iodinii Composita (Iodine ^ss; potass, 
iod. gj ; alcohol Oj). Dose, gtt. x-xx (.65 to 1.30 Gm.). 

Liquor Iodinii Compositus (Iodine 3yj ; potass. 
iod. ,^jss ; water Oj). Dose, gr. v-x (.30 to .65 Gm.). 

Unguentum Iodinii (Iodine gr. xx, potass, iod. gr. iv 
to gj). 

Unguentum Iodinii Compositum (Iodine gr. xv, 
pot. iod. gr. xxx, lard ^j). 

Liquor Arseniei et Hydrargyri Iodidi (Dono- 
van's Solution). Dose, gtt. v-x (.30 to .65 Gm.). 

Syrupus Ferri Iodidi (iodide of iron, 7^ gr. to f3j). 
Dose, n^x-xxx (.65 to 2. Gm.). 

Pilulffi Ferri Iodidi (ferri iodid. gr.j ; ferri redact, gr. J). 

Also enters into Sulphuris Iodidum, Unguentum Sulphuris 
Iodidi, Arseniei Iodidum, Hydrargyri Iodidum Rubrum, 
Unguentum Hydrargyri Iodidi Rubri, Hydrargyri Iodidum 
Viride, Plumbi Iodidum, Potassii Iodidum, and Unguentum 
Potassii Iodidi. 

Antidotes. 

Starch and demulcents. 

Incompatibles. 

With Iodine — Alkalies and alkaloids (quinia and strych- 
nia) ; extracts containing starch ; water precipitates the 
iodine from tinetura iodinii. The compound tincture may 
be diluted with water without precipitation. 

With Potassii Iodidum -Acids, acetate of lead, and the 

metallic salts generally. 

With Ferri Iodidum. — Lime-water, alkalies, and the 
vegetable astringents.] 

Local Actions. 

Physiological. Therapeutical. 

Iodine in substance is It is therefore of some 
never used save for its anti- value for the correction of 
septic properties. Dissolved fetor in drains, etc. 



288 



IODINE. 



in spirit, however, it is an 
excellent counter - irritant, 
producing itching and smart- 
ing of the skin, with desqua- 
mation of cuticle, and even 
blistering if the application 
be too frequently repeated. 
It has been shown that this 
local action of iodine is at- 
tended by a very free extru- 
sion of colorless blood cor- 
puscles into the subcutaneous 
cellular tissue. 

Experiment has proved 
that iodine is not absorbed 
into the system through the 
unbroken cuticle. [But fatal 
poisoning has resulted from 
absorption of a solution of 
iodine, which had been in- 
jected into an ovarian cyst. 

Iodine and the soluble 
iodides are incompatible with 
the alkaloids as well as with 
most metallic salts in solu- 
tion.] 



The tincture or liniment 
of iodine is very extensively 
used as a counter-irritant 
application to enlarged 
glands, chronic abscesses, 
swollen joints, chilblains, and 
to various forms of skin 
disease, more especially the 
common varieties of ring- 
worm, which speedily yield 
to this treatment. It is very 
useful when painted over the 
chest in chronic pneumonia 
and fibroid and tubercular 
affections of the lungs ; and 
Mr. Jordan, of Birmingham, 
has recently drawn attention 
to the great success attained 
by him in the dispersion of 
boils, carbuncles, and suppu- 
rating glands by iodine 
freely applied to a neighbor- 
ing vascular area. 

It is also an excellent in- 
jection into various secreting 
cavities, curing hydrocele by 
obliterating the sac of the 
tunica vaginalis, acting well 
on the same principle in some 
rare cases of ovarian dropsy 
and bronchocele, and deo- 
dorizing and lessening dis- 
charges in empyema and 
suppurating glands. [\\\ 
scrofula, Lugol's solution may 
be injected directly into the 
enlarged glands, with great 
benefit.] 

[For the Constitutional Effects, see Iodide of Potas- 
sium.] 



IODOFORM — IPECACUANHA. 289 



[IODOFORMUM— IODOFORM. 

In yellow, scaly crystals having the odor of saffron. It is insoluble in 
water, but soluble in alcohol, ether, and the fixed and volatile oils. By 
a heat above 250° it is decomposed, giving off violet vapors. U. S. 

It is prepared by decomposing an alcoholic solution of 
iodide of potassium with lime. As a local anaesthetic, it is 
applied in powder to painful ulcers, whether chronic, can- 
cerous, or syphilitic, where it relieves pain and promotes 
cicatrization. Suppositories (gr. v— x) are used in haemor- 
rhoids and uterine cancer. In ethereal solution (20 per 
cent.), it has been highly recommended as an application in 
chronic inflammation of the throat. 1 ^ 



IPECACUANHA— IPECACUANHA. 

[ The root of Cephadis Ipecacuanha, U. S. 

Officinal Preparations, U. S. 

Extraetum Ipecacuanhas Fluidum. Dose, gtt. 
xxx (2. Gm.). 

Pulvis Ipecacuanhas Compositus. Dover's pow- 
der (ipecac, gr. j, opium gr. j, carb. potass, grs. viij.). Dose, 
gr. x (.65 Gm.). 

Troehisei Ipecacuanhas. 

Trochisci Morphias et Ipecacuanhas (Morphia 

Syrupus Ipecacuanhas (extract fgij to syrup xxx). 
Dose, f3j_f 3ss (2. to 16. Gm.). 

Vinum Ipecacuanhas (f^ij extract, to sherry wine 
fgxxx). Dose, f3j-iv (4. to 16. Gm.).] 

Local Actions. 

Physiological. Therapeutical. 

The prolonged application The use of the slowly act- 

of ipecacuanhas to the skin ing and pustulating forms of 

causes some irritation, fol- counter-irritation has fallen 

lowed by the appearance of out of fashion, as they are 

vesicles, pustules, and even not only disfiguring, but give 

> [Phila. Med. Times, vol. iv. p. 4, 1873.] 
25 



290 



IPECACUANHA. 



troublesome ulceration. In 
some persons the powdered 
root causes violent irritation 
of the respiratory passages, 
ranging from symptoms re- 
sembling hay-fever up to a 
spasmodic condition analogous 
to true asthma. 



less relief than more sedative 
applications. 

The only way in which we 
find ipecacuanha employed 
locally is in the form of 
spray, which Prof. Ringer 
has found very useful in 
chronic bronchitis, winter 
cough, bronchial asthma, 
with emphysema and fibroid 
phthisis. As the pure wine 
may cause nausea and irrita- 
tion, he advises a dilution 
with from 1 to 2 parts of 
water, using the ordinary 
spray - producer, beginning 
with about twenty squeezes 
for the first sitting, once a 
day, but afterwards more fre- 
quently repeated, the mouth 
being well rinsed out after 
each application. Cases of 
winter cough were generally 
cured in twelve days. 



Constitutional Actions. 



1. Brain and Nervous 

System 1. No effect seems 

to be produced on the brain. 

2. Ipecacuanha has a mark- 
edly stimulating influence on 
that centre in the medulla 
oblongata which presides 
over the action of vomiting. 
Whether by subcutaneous 
injection, or by being taken 
into the stomach, it causes, 
within a moderate period, a 
decided but mild emetic ef- 
fect ; and as this may arise 
either from irritation of the 
mucous membrane of the sto- 



2. Ipecacuanha cannot be 
recommended in cases of 
poisoning, fornot only does 
it act too slowly, but its nau- 
seating and depressing influ- 
ence may be injurious. It 
is of great service, however, 
in many of those affections 
of the throat or respiratory 
organs where we wish to 
empty the lungs or detach 
foreign bodies or false mem- 
branes from the larynx or 



IPECACUANHA. 



291 



mach, or from a primary stim- 
ulation of the vomiting centre 
itself, ipecacuanha must be 
ranked among both the di- 
rect and the indirect emetics. 

Emetia given by subcu- 
taneous injection is much 
slower in its action, and re- 
quires to be given in larger 
doses than by the. mouth, 
which proves that it must 
primarily act on the mucous 
membrane of the stomach. 

It may be said generally to 
occupy a middle place be- 
tween sulphate of zinc and 
tartar emetic, being neither 
so prompt as the first, nor so 
nauseating as the second. It 
has been found by experi- 
ment to cause diminution of 
tactile sensibility and para- 
lysis of the lips, not unlike 
glosso-pharyngeal paralysis, 
and depending probably on 
exhaustion of the medulla 
oblongata by the vomiting 
act. 

II. Circulation Ipecacu- 
anha has no direct influence 
on the heart or circulation, 
save the usual depression fol- 
lowing nausea and vomiting. 

III. Respiration and Tem- 
perature. — No effect is pro- 
duced on the rapidity of the 
respiratory function, save the 
temporary acceleration usu- 
ally accompanying the act of 
vomiting. There seems no 
doubt, however, that ipeca- 
cuanha causes an increased 
secretion from the mucous 



trachea, as in bronchitis, 
croup, diphtheria, etc. 

A most remarkable fact in 
the action of this drug is its 
power, when given in small 
doses, of checking vomiting. 
Thus, in the vomiting of 
nursing, pregnancy, or men- 
struation, in the irritability 
of stomach of children, and 
in other dyspeptic conditions 
in which nausea or vomiting 
are prominent symptoms, a 
drop of ipecacuanha wine 
taken every hour will often 
prove truly curative. At 
present this must be looked 
upon as one of the enigmas 
of therapeutics. 



III. Ipecacuanha is there- 
fore a most useful expecto- 
rant, thinning and diluting; 
the pulmonary mucus, and 
thus facilitating its expulsion. 
It is hence almost universally 
employed in bronchitis, com- 
mon catarrh, winter cough, 
etc. It was formerly used, 
and with some alleged sue- 



292 



IPECACUANHA. 



membrane of the bronchial 
tubes. After poisoning by 
ipecacuanha, the lungs have 
generally been found in a 
bloodless condition in the 
early stages, followed by in- 
tense congestion. 



IV. Digestive and Secret- 
ing Organs. — 1. Stomach 

and Intestines As already 

noted, ipecacuanha causes 
some irritation of the termi- 
nal filaments of the pneumo- 
gastric nerve distributed to 
the stomach, and thus sets 
in motion the reflex machin- 
ery necessary to produce vo- 
miting. On the mucous lin- 
ing of the intestinal canal, 
also, its effects are undoubted, 
as indicated by its action in 
disease ; but we are at pre- 
sent unable to give any sat- 
isfactory explanation of its 
often marvellous influence 
over dysentery in its various 
forms. 



cess, in hcemoptysis, 5-grain 
doses repeated at short in- 
tervals exerting a marked 
depressing effect, and thus 
checking the tendency to 
bleeding ; but with the intro- 
duction of more effectual re- 
medies, this mode of treat- 
ment has now fallen into dis- 
use. 

IV. — 1. Ipecacuanha is 
indicated in some overloaded 
conditions of the stomach, 
caused by excessive indul- 
gence either in food or drink ; 
and the dull aspect, coated 
tongue, foul breath, head- 
ache, and nausea, may be 
promptly relieved by a good 
emetic dose. 

In acute dysentery, ipeca- 
cuanha is now looked upon as 
a never-failing specific. It 
must here be taken in full 
doses, from 15 to 20 grains 
being given ^t once and re- 
peated in two hours ; and al- 
though the first dose may be 
rejected by the stomach, 
toleration is speedily estab- 
lished, and no more vomiting 
is produced. Some authori- 
ties recommend a previous 
administration of laudanum 
to quiet the stomach. Decker 
goes further than this, and 
advises 60 to 90 grains in one 
dose, which often seems to cut 
short the disease. Let the 
patient after taking this re- 
main quietly on his back for 
at least 10 or 1 2 hours before 
repeating the dose, and even 



IPECACUANHA. 



293 



\ 



2. Liver. — Ipecacuanha 
seems to have some stimulat- 
ing power over the hepatic 
secretion. 



3. Skin. — Ipecacuanha 
promotes slightly the cuta- 
neous secretion, independent- 
ly of the tendency to perspira- 
tion usually attending the ac- 
tion of emetics. 



then we must be guided by 
symptoms. 

Under this treatment the 
pain and tenesmus rapidly 
subside, the motions regain 
natural color and consistence, 
and the patient makes a satis- 
factory recovery. 

In cases of dysenteric diar- 
rhoea so often met with in 
this country, and more espe- 
cially in children, ipecacu- 
anha in much smaller doses 
is also a very effectual rem- 
edy, the indications for its 
use being any appearance of 
blood or mucus in the stools, 
with pain and straining. In 
the more ordinary forms of 
diarrhoea, however, it is quite 
useless. 

2. It has therefore been 
given in the form of pill, and 
combined with other reme- 
dies, to relieve the sluggish 
digestion caused by a defi- 
ciency of bile. 

• 3. Ipecacuanha combined 
with opium, in the form of 
"Dover's Powder," is a 
well-known and tolerably 
effectual diaphoretic, much 
used in chronic rheumatism 
and feverish attacks. 



Mode of Elimination, etc. 

It is probable that as much of the ipecacuanha as remains 
after the action of vomiting is eliminated from the system 
by the biliary and intestinal secretions. 



25* 



294 JALAP. 

Mode of Administration. 

The action of ipecacuanha wine is so notoriously uncer- 
tain, that, when we wish to obtain the full emetic effect of 
the drug, it is best to have recourse to the freshly powdered 
root (15 to 30 grains, or 1. to 2. Gm.), remembering, however, 
that children will bear unusually large doses. 

In the treatment of dysentery, also, we shall derive most 
advantage from the use of the powder, and in ordinary cases 
of dysenteric diarrhoea we may give from ^ to 2 or 3 grains 
in combination with compound tragacanth powder. 

Vinum ipecacuanhas, in doses of from tilx to 5j> is an 
almost invariable ingredient of cough mixtures. 

[Emetia, the alkaloid of ipecacuanha, is not officinal, but 
is an efficient emetic in doses of gr. T L to ^ (.005 to .01 Gm.).] 



JALAPA— JALAP. 

[The tuber of Exogonium purga (Bentham, Botanical Register}, 
Ipomoza Jala-pa (Nuttall), U. S. 

Dose, in substance, gr. x-xxx (.GO to 2. Gm.). 

Officinal Preparations, U. S. 

Extractum Jalapae. Dose, gr. v-x (.30 to .65 Gm.). 

Pulvis Jalapae Compositus (jalap 1 part, cream of 
tartar 2 pts.). Dose, gr. xx-5j (1.30 to 4. Gm.). 

Resina Jalapae. Dose, gr. ij-iv (.12 to .25 Gm.). 

Tinetura Jalapae (powder ^iij-Oj). Dose, 5j-ij (4. 
to 8. Gm.).] 

Physiological Action. Therapeutical Action. 

The action of jalap resem- Jalap is undoubtedly one 
bles that of scammony, only of our best hydragogue ca- 
differing in being less irri- thartics, and is much used in 
tant and more effectual in cerebral lesions, in kidney 
promoting the flow of watery disease, where the excretion 
fluids from the bowels. of effete products threatens 

to become suspended, and 
when dropsy is setting in ; 
in such cases smart purgation 
by pulv. jalap, co. will often 
produce striking benefit. 



BUTTERNUT — JUNIPER. 295 

111 cardiac disease, also, 
when the right side of the 
heart is engorged by emphy- 
sema or bronchitis, free ca- 
tharsis will unload the dis- 
tended and laboring organ, 
and relieve the condition of 
intense dyspnoea, with the 
cold and livid surface and 
indications of approaching 
death. Jalap also acts well 
as an ordinary or habitual 
purgative, and is generally 
prescribed in the form of the 
compound powder, containing 
cream of tartar. 



[JUGLANS— BUTTERNUT. 

The inner bark of the root of Juglans cinerea, U. S. 

Officinal Preparation, U. S. 

Extraetum Juglandis. Dose, as a laxative, gr. v-x ; 
as a purgative, gr. xx-xxx (.30 to 2. Gin.). 

Juglans is an indigenous cathartic resembling rhubarb in 
its property of evacuating without debilitating the bowels. 
Mild and efficient in its action, it is w T ell adapted to habitual 
constipation. It may be given in decoction, or in the form 
of the officinal extract.] 



JUNIPERUS— JUNIPER. 

[The fruit of Juniper us communis, U. S. 

Officinal Preparations, U. S. 

Infusum Juniperi (berries gj to Oj). Dose, fjfij-iv 
(64. to 128. Gm.). 

Oleum Juniperi. Dose, gtt. v-xv (.30 to 1. Gm.). 

Spiritus Juniperi Compositus (oil f'5jss in Oviij): 
Dose, f'3ij-iv (8. to 1G. Gm.). 

Spiritus Juniperi (oil fgj in Oiij). Dose, f3ss-j (2. 
to 4. Gm.).] 



296 



KINO. 



Physiological Action. 

Juniper stimulates the ac- 
tion of the kidneys, but, like 
many other remedies of its 
class, only increases the flow 
of urine where dropsy exists. 
It has been shown that in a 
healthy man the quantity of 
the urine is actually dimin- 
ished, whilst the urea is in- 
creased. 

[When an overdose is 
given, even strangury and 
total suppression may result. 
In small doses it is a gentle 
stimulant to the kidneys.] 



S. 



Therapeutical Action. 

Juniper is a good diuretic, 
generally used in combina- 
tion with other drugs, and 
acting either when swallowed, 
or inhaled in the form of 
vapor. 



Spiritus juniperi 

Potassii acetatis 


f ^ss ; 

5iss ; 


or 


161 
6 


Gm. 
u 


Spiritus ?etheris liitrosi 
Decocti scoparii [Br.] 
Dose, f ^j ter die. 


f^vnj ; 




32 
256| 


(I 
a 


ic mixture. 











M. 



KINO— KINO. 

[ The inspissated juice of Pterocarpus Marsupium (De Candolle) and of 

other plants, U. S. 

Officinal Preparation. 

Tinetura Kino (gss to Oj). Dose, f 3j (4. Gm.).] 



Physiological Action. 

Kino is astringent in vir- 
tue of the tannin which it 
contains. 



Therapeutical Action. 

It may therefore be used 
in diarrhoea and other cases 
where astringents are indi- 
cated, but it seems to have- 
no special advantage over 
other remedies of the same 
class. 



RHATANY — LACTUCARIUM. 291 

KRAMERIA— RHATANY. 

[ The root of Krameria triandra (De Candolle), U. S. 
Dose, in substance, gr. xx (1.30 Gm.). 

Officinal Preparations, U. S. 

Extractum Krameriae. Dose, gr. v-x (.30 to .65 
Gm.). 

Extractum Krameria^ Fluidum. Dose, gtt. xx 
(1.30 Gm.). 

Infusum Krameria^ (3j to Oj). Dose, f^j-ij (32. to 
64. Gm.). 

Syrupus Krameria?. Dose, f'^ss (16. Gm.). 

Tinetura Krameria? (|iij to Oj). Dose, f^j-ij (32. 
to 64. Gm.).] 

Physiological Action. Therapeutical Action. 

Krameria has powerful as- Rhatany has been used 
tringent properties, due, no with success in dysentery and 
doubt, to the tannin which diarrhoea, but is probably 
it contains. [It is also gently inferior to many other reme- 
tonic, and is much esteemed dies of the same class, and is 
in Peru in treatment of bowel therefore but seldom em- 
affections.] ployed. [It is frequently 

added to chalk mixture, in 
the treatment of diarrhoea of 
relaxation.] 



[LACTUCARIUM— LACTUCARIUM. 

The concrete juice obtained from Lactuca sativa, by incision and 
spontaneous evaporation, U. S. 

Dose, gr. xx (1.30 Gm.). 

Officinal Preparation, U. S. 

Syrupus Laetuearii (gj to Oj). Dose, f gss (16. 
Gm.). 

Lactucanum, or Lettuce-opium, is a feeble narcotic, and 
is considered slightly laxative and diuretic. It has been 
used as a substitute for the other narcotics in phthisis and 
in diseases of children.'] 



298 LAVENDER — LEMON. 

[LAVANDULA— LAVENDER. 

The flowers of Lavandula vera (De Candolle), U. S. 

Officinal Preparations, U. S. 

Oleum Lavandulae. Dose, gtt. iij-x (.20 to .60 Gm). 

Spiritus Lavandulae. Dose, f3ss-j (2. to 4. Gm.). 
Enters into Mist una Ferri Composita. 

Spiritus Lavandulae Compositus. Dose, 3j-iv 
(4. to 16. Gm.). 

Lavender is a carminative, but is rarely used except in 
combination. The compound spirit is its most elegant pre- 
paration, and is a very agreeable stomachic and cordial. 
The oil is used in perfumery.] 



[LEPTANDRA— LEPTANDRA. 

The root of Leptandra Virginica (Nuttall). U. S. 

Culver's root is emetic and cathartic, and is also con- 
sidered cholagogue. Dose of the powdered root, gr. xx to 
5j (1.30 to 4. Gm.). In small doses (gr. ij-v, or .12 to 1 .30 
Gm.), it is said to resemble rhubarb. The fluid extract 
(not officinal) is aperient in doses of ni^x to f'3J (-60 to 4. 
Gm.).] 



LIMONES— LEMON. 
[ The fruit of Citrus Limonum {De Candolle), U. S. 

Limonis Cortex. Lemon Peel. 
Limonis Suceus. Lemon Juice. Dose, f^j-iv (32. 
to 128. Gm.). 

Oleum Limonis. Oil of Lemon. Used for flavoring. 
Aeidum Citrieum. Citric Acid. 

Officinal Preparations, U. S. 

Spiritus Limonis. Used for flavoring purposes. 
Mistura Potassii Citratis. Neutral Mixture. Dose, 
% f Jj-ij (32. to 64. Gm.). 

Syrupus Limonis. As a vehicle. 
Spiritus Ammoniae Aromatieus. > Dose, fjss-j 
(2. to 4. Gm.). 
Syrupus Aeidi Citrici. As a vehicle.] 



LEMON. 299 

Constitutional Action. 

Lemon-peel is in some measure tonic and anti-spasmodic, 
and is a useful flavoring ingredient, but lemon-juice has some 
important properties which are purely therapeutical, and 
cannot be explained by any action which it possesses over 
the healthy organism. 

In the first place Ave must rank its antiscorbutic virtues, 
acting as it does both by preventing and by curing the dis- 
ease, and by its universal use afloat nearly stamping out the 
ravages of what used to be an almost invariable attendant on 
long voyages at sea. The occurrence of scurvy to any ex- 
tent on board ship is now looked upon as a clear indication 
that the regular administration of lime or lemon-juice has 
been neglected, and that the crew has been attacked by a 
painful and dangerous disease, the absolute preventability of 
which experience has amply confirmed. Various explana- 
tions have been given of the cause of scurvy, and there is no 
doubt that it is usually associated with an absence of fresh 
meat and vegetables from the diet scale. Dr. Garrod, how- 
ever, goes further, and teaches that the essence of the dis- 
ease lies in a deficiency of the potash salts ; whilst Mr. 
Morgan, of Dublin, is no less convinced that the absence of 
phosphoric acid is the real cause — both agreeing in this, 
however, that the presence of this special ingredient in 
lemon-juice explains its superiority over citric acid, which is 
in no degree an antiscorbutic. It is unfortunate that lime- 
juice is bulky, and liable to become solid at low tempera- 
tures, and must be also administered in such considerable 
doses as to give some excuse for its occasional neglect on 
expeditions where every ounce of extra weight entails in- 
creased toil and danger. It is to be hoped that some more 
convenient and portable means of using this invaluable drug 
may yet be introduced. 

Lemon-juice was formerly vaunted as a specific for acute 
rheumatism, and although this has not been confirmed by 
experience, there is no doubt that persons afflicted with 
chronic rheumatic pains may often derive benefit from taking 
a tablespoonful of this agreeable remedy two or three times 
a day with their meals. Lemon-juice has also been called a 
refrigerant, but its sole claim to this title rests upon the 
great facility with which we may construct refreshing effer- 
vescing draughts by its aid. 



300 



FLAXSEED. 



[Liniment a. 

The officinal Liniments are — 



Linimentum Aconiti 

' ' Ammonire 

" Calcis 

" Caniphorse 

" Cantliaridis 



Linimentum Chloroformi 

" Plumbi Subacetatis 

il Saponis 

" Terebinthinee.] 



LINUM—FLAXSEED. 

[ The seed of Linum usitatissimum, U. S. 

Oleum Lini. Flaxseed oil (Linseed oil). 
Lini Farina. Ground flaxseed (Linseed meal). 

Officinal Preparations, U. S. 

Infusum Lini Compositum. As a demulcent. Dose, 
fgj-iv (32. to 128. Gm.). 

Ceratum Resina^ Compositum. Deshler's Salve. 
Linimentum Caleis. Carron oil. (For burns.)] 



Local 

Physiological. 

Linseed meal, in the form 
of poultice, is the most con- 
venient and effectual way of 
applying continuous moist 
warmth to the surface of the 
body. Thus used, it relieves 
pain, relaxes spasm, and is 
generally soothing and agree- 
able to the feelings of the pa- 
tient. By relaxing the super- 
ficial vessels, a poultice may 
be in some measure antiphlo- 
gistic, and may also relieve 
the congestion of internal or- 
gans by drawing blood to the 
cutaneous surface and pro- 
moting perspiration there. 



Action. 

Therapeutical. 
A linseed poultice is a very 
soothing and effectual appli- 
cation in all acute affections 
of the lungs. Not only does 
it relieve pain, but it keeps 
up a warm equable temper- 
ature, and rests the affected 
organ by restricting in some 
degree the movements of the 
chest walls. It may also be 
used with advantage in peri- 
tonitis, in colic, in various 
inflammatory affections of the 
throat, and in boils, abscesses, 
etc., where, if it does not suc- 
ceed in arresting the suppu- 
rative process, as occasionally 
happens, it facilitates and 
hastens the breaking down of 
inflammatory products into 



LITHIUM. 301 

pus, and thus encourages the 
process of ripening. After 
the opening of the abscess, 
poultices cannot be recom- 
mended, as they are nauseous 
and dirty, and we would 
much rather advise the case 
to be treated on the antiseptic 
principles of Mr. Lister. 

Linseed oil is an old-fash- 
ioned treatment for burns, 
and, combined with lime- 
water, was formerly exten- 
sively used under the name 
of Carron oil. 

Internal Use. 

An infusion of linseed is Under the name of linseed 

rather soothing in character, tea, this infusion is much 
probably owing to the muci- used in domestic medicine 
lage which it contains. as a soothing remedy for 

coughs. 

Mode of Administration. 

When used as an application in pleurisy or pneumonia, a 
poultice must extend fairly round the chest ; it should be 
about a quarter of an inch thick, and must be changed not 
seldomer than every two hours, as it soon tends to become 
dry, hard, and uncomfortable. It is best made by slowly 
adding the meal to boiling water, stirring vigorously mean- 
while, and afterwards incorporating with it a certain amount 
of olive oil, which prevents its adhering to the surface. [A 
piece of oiled silk should be placed outside of the poultice to 
retain its warmth and moisture.] Occasionally its use seems 
to irritate the skin, and cause a crop of small boils and painful 
pustules, and it must, therefore, as a general rule, be avoided 
in moist cutaneous affections. 



LITHIUM—LITHIUM. 

[Lithii Carbonas. Carbonate of Liihia. Dose, gr. 
iij-vj (.20 to .40 Gm.). 

Lithii Citras, Citrate of Lithia. Dose, gr. v-x (.30 
to .65 Gm.).] 
26 



302 LOBELIA. 

Physiological Effects. Therapeutical. 

Lithia forms a very soluble Lithia is, therefore, a vain- 

salt with uric acid, probably able remedy for gout, and 
in the blood, and, therefore, uric acid gravel, given either 
prevents the deposition of in the form of effervescing 
chalky formations in the tis- lithia water, lithia? carbonas, 
sues. or lithia? citras. 

It also causes an increase It, therefore, acts as a diu- 
in the urinary secretion. retic perhaps more powerfully 

than any of the other alkaline 

salts. 



LOBELIA— LOBELIA. 

[ The leaves and tops of Lobelia inflata, U. S. 

Officinal Preparations, U. S. 

Acetum Lobelise (f^ij to Oj). Dose, from gtt. x to 
f3j_ij (.65 to 8. Gm.). 

Tinetura Lobelise (f^ij to Oj). Dose, the same. 

Antidote. 

The stomach should be washed out with warm solution of 
tannic acid, and symptoms of collapse treated as they arise, 
by stimulants, frictions, counter-irritants, sinapisms, and 
anodynes.] 

Local Action. 
Lobelia possesses no local action. 

Internal Actions. 

Physiological. Therapeutical. 

1. Brain and Nervous Sys- 
tem In large doses, lobelia 

frequently causes headache 
and giddiness, and may even- 
tually extinguish life by para- 
lyzing the respiratory centre. 

2. Heart and Circulation. 
— Lobelia depresses the ac- 
tion of the heart, and in this 



LOBELIA. 



303 



respect has a powerful affinity 
to tobacco. 

3. Respiration and Tem- 
perature As already men- 
tioned, lobelia in large doses 
is a respiratory depressant, 
but in ordinary medical prac- 
tice it seems to relieve spas- 
modic conditions of the bron- 
chial tubes. 

It lowers the temperature 
in some measure, on account 
of its diaphoretic action. 



3. Lobelia is only used in 
medicine in this country as 
a remedy for various respi- 
ratory affections, and more 
especially spasmodic asthma. 
Its action here is apt to be 
uncertain, and it may unex- 
pectedly cause much nausea 
and discomfort ; but Ringer 
tell us that we may employ 
it with great confidence by 
giving much larger doses than 
are usually prescribed. 

Remember that its action 
in no way prevents the asth- 
matic attack, but merely cuts 
it short. 

4. Lobelia is never used 
as an emetic, being slow, un- 
certain, harsh, and exhaust- 
ing. 



4. Secreting and Digestive 
Organs Lobelia has un- 
doubted emetic properties, 
and frequently causes vomit- 
ing, accompanied by much 
nausea and general depres- 
sion. 

Skin Lobelia excites the 

action of the skin. 

Kidneys. — Lobelia is said 
to promote the excretion of 
watery fluids by the kidneys. 



Dose. 

Ringer tells us that the dose laid down in our usual text- 
books is much too small, and that we may freely administer 
a drachm of the ethereal tincture [same strength as tinct. 
lobelia, U. S.] every hour, or ten minims every ten minutes, 
with advantage, immediately before and during the asthmati- 
cal paroxysm. [The vinegar of lobelia is said to be the best 
preparation for internal use.] 

The great drawback to its use is the occasional unpleasant 
symptoms following its administration, and which can be, 
unfortunately, neither foreseen nor prevented. 



304 LYCOPODIUM — MAGNESIUM. 

[Liquores. 

The officinal Liquors are — 

Liquor Ammonii Acetatis Liquor Iodinii Compositus 

" Arsenici Chloridi " Magnesii Citratis 

" et Hydravg. Iodidi " Morphiae Sulphatis 

" Barii Chloridi " Plumbi Subacetatis 

" Calcii Chloridi " " " Dilutus 

" Calcis " Potassae 

" Ferri Chloridi " Potassii Arsenitis 

" ' Citratis " " Citratis 

" " Nitratis " " Permanganatis 

" " Subsulphatis " Sodse 

" " Tersulphatis " " Chlorinate 

" Gutta-perchae " Soclii Arseniatis 

" Hjdrargyri Nitratis " Zinci Chloridi.] 



[LYCOPODIUM— LYCOPODIUM. 

The sporules of Lycopodium clavalum, and other species of 
Lycopodium, U. S. 

Lycopodium is an extremely light, very fine powder, of 
a delicate yellow color, inodorous, tasteless, and very inflam- 
mable, so that it flashes like gunpowder when thrown into 
the flame. It is used as a dusting powder for chafing, but 
should not be used when the skin is broken. It is also em- 
ployed to coat pills in pharmacy.] 



MAGNESIUM— MAGNESIUM. 

[Magnesii Carbonas. Carbonate of Magnesia. Dose, 
3ss-3j (2. to 32. Gm.). 

Magnesii Sulphas. Sulphate of Magnesia (Epsom 
salt.) Dose 5ss-j (16. to 32. Gm.). 

Officinal Preparations, U. S. 

Magnesia. Dose, 5,i-i v (4. to 16. Gm.). 
Trochisei Magnesias (each containing gi\ iij). 
Liquor Magnesias Citratis. Dose, f 3y-iv (32. to 
128. Gm.).] 



MAGNESIUM. 



305 



Internal Uses. 



Magnesia and its carbon- 
ate have a great capacity for 
saturating and neutralizing 
acid, and secondly, on becom- 
ing converted into bicarbon- 
ate by the carbonic acid of 
the intestines, they produce 
a mildly laxative effect. 

Sulphate of magnesia acts 
much more powerfully, and 
causes profuse watery evacu- 
ations, and its action may be 
thus explained : — 

In virtue of its low diffu- 
sive power, it does not readily 
find its way into the blood, 
but, remaining in the intes- 
tines, it attracts and firmly 
retains the watery fluid it 
finds there, and thus prevents 
its reabsorption. But, in ad- 
dition to this, and to increas- 
ing the intestinal secretion, 
recent experiment has shown 
that it also actually with- 
draws fluid from the veins, 
as proved by the rapid way 
in which a small portion of 
intestine isolated from the 
rest of the tube becomes 
filled with watery fluid after 
the introduction of sulphate 
of magnesia. 



They are therefore antacid, 
and relieve pain or heart- 
burn, and are also gentle 
purgatives, much used, more 
especially for children. Their 
tendency, however, to form 
concretions, when employed 
too long, limits their use in 
this respect. 

Sulphate of magnesia is a 
very commonly used purga- 
tive in doses of from 3.) to 
Jjss in simple constipation, 
in the early stages of small- 
pox and feverish conditions, 
in chronic lead-poisoning, 
and, combined with iron, in 
many atonic conditions of the 
system. 



Mode of Administration. 

As sulphate of magnesia is not only very nauseous, but, 
when taken alone, may cause griping, straining or uncom- 
fortable abdominal distension, it is usually prescribed in com- 
bination w T ith senna, cardamom, and liquorice, as in the 
mist, sennae co. [Br.], or with a little acid and sulphate of 
iron, both of which seem to increase its purgative properties ; 

26* . 



306 MANGANESE — MANNA. 

and it is well to remember that free dilution also seems to 
enhance its effects. The following are good formulae : — 

R. Magnesii sulphatis §ij ; or 64] Grin. 

Syrupi zingiberis f §ss ; " 16 " 

Infusi rosse comp. ad ffviij ; " 256 " M. 

S. 3J tertiis lioris. 

IJ. Magnesii sulphatis §ij ; or 64 Gm. 

Ferri sulphatis gr. xxiv ; " 1 60 

Acidi sulphurici diluti f.^ij ; " 8 

Infusi quassiae ad f § viij ; "256 

Misce, fiat mistura, cujus capiat unciain unaui omni mane. 

H. Magnesii sulphatis §ij ; or 64 Gm. 

Magnesii carbonatis 5ij ; " 8 " 

Syrupi zingiberis f§j ; " 32 " 

Aqua? mentha? piperita? ad ffviij ; " 256 " 

Misce, fiat mistura. Sumat unciam unam quartis horis ad 
effectum, phiala prius bene agitata. 



[MANGANESIUM— MANGANESE. 

Manganesii Oxidum Nigrum. Black oxide of 
Manganese (used in making oxygen, chlorine, and aqua chlo- 
rini) has been administered in doses of gr. iij-xx (.20 to 
1.30 Gm.). 

Manganesii Sulphas. Sulphate of Manganese. Dose, 
gr. v-xx (.30 to 1.30 Gm.). 

Internal Effects and Uses. 

Sulphate of manganese acts as a purgative in doses of 
5j-ij (4. to 8. Gm.), and in smaller doses has cholagogue 
properties. It has been used as a substitute for iron, as a 
hcematinic. Dr. Hammond reports its successful use in 
chorea. In divided doses it has been given in gastralgia, 
pyrosis, and indigestion.^ 

MANNA— MANNA. 

[ The concrete saccharine exudation, in flakes, of Fraxinus Ornus and of 
Fraxinus rotundifolia, U. S.~\ 

Internal Effects and Uses. 

Has very slight purgative properties. [It is generally 
given in infusion combined with senna, but may be used 
alone boiled in milk for children, to whom its sweet taste 
makes it acceptable. Dose, for a child, 3J-"j (4. to 12. Gm.).] 



ARROWROOT- — MATICO. 307 

[MARANTA— ARROWROOT. 

Thefecula of the rhizome of Maranta Arundinacea, U. S. 
Enters into Trockisci Ipecacuanhas. 

Uses. 

Arrowroot is demulcent;, and forms an agreeable article oi 
diet for tke sick and for infants.] 



[MARMOR— MARBLE. 

Native, white, granular Carbonate of Calcium, U. S. 

Used as a source for Carbonic Acid Gas, and in making 
Aqua Acidi Carbonici, and Liquor Calcii Chloridi. (See 
Calcium.)] 



[MARRUBIUM— HOREHOUND. 

The leaves and tops of Marrubium vulgare, U. S. 

Used as a domestic remedy for cougks and colds and as a 
diaphoretic, in tke form of decoction (^j to Oj), syrup, and 
candy.] 



MASTICHE— MASTIC. 

[ The concrete resinous exudation from Pistacia Lentiscus, U. S. 

Enters into Pilulse Aloes et Mastickes.] 
Tkis is only used as a filling for decayed teeth in dental 
surgery. 



MATICO— MATICO. 

[The leaves of Artanthe elongata (Miguel), U. S. 

Officinal Preparation, U. S. 

Extr actum Matico Fluidum. Dose, f 5ss-j (2. to 
4. Gm.).] 

Matico is only used externally as a local application for 
tke arrest of hemorrhage ; and it is generally believed that 
it acts mechanically by the roughly-reticulated under surface 
of the leaf entangling the blood and forming clots. No sue- 



308 GERMAN CHAMOMILE — HONEY. 

cess has attended its internal administration. [In the form 
of the fluid extract, Matico has been highly recommended 
in hemorrhages and diseases of mucous membranes, includ- 
ing gonorrhoea and leucorrhcea.~\ 



[MATRICARIA— GERMAN CHAMOMILE. 

The floivers of Matricaria Chamomilla, U. S. 

Resembles chamomile in its properties, but is rarely used 
in America.] 



[MEL— HONEY. 

A saccharine liquid prepared by Apis mellifica, U. S. 

Officinal Preparation, U. S. 
Mel Despumatum. Clarified Honey. 

Uses. 

Enters into Confectio Aromatica, Confectio Opii, Con- 
fectio Rosas, Oxymel (Br.), Mel Rosas, Mel Sodii Boratis, 
Pilula Ferri Carbonatis, Pilulas Quinias Sulphatis, Tinctura 
Cardamomi Composita, and Tinctura Opii Composita. 

Its agreeable taste and demulcent qualities make honey 
a useful vehicle for distasteful powders, and render it an 
acceptable addition to gargles. Purified honey is a good 
excipient for pills, and forms the basis of the Mellita, which 
are used chiefly in washes for the throat and mouth.] 



[Mellita. 

The class of Honeys comprises Mel Rosas and Mel Sodii 
Boratis.] 



PEPPERMINT — MEZEREON. 309 

[MENTHA PIPERITA— PEPPERMINT. 

The leaves and tops of Mentha piperita, U. S. 

MENTHA VIRIDIS— SPEARMINT. 

The leaves and tops of Mentha viridis, U. S. 

Officinal Preparations, U. S. 

Aqua Menthae Piperita^. Used as a vehicle. 

Oleum Mentha^ Piperita^. Dose, gtt. iij-x (.20 to 
.60 Gm.). 

Spiritus Mentha^ Piperita^. Dose, gtt. x-xx (.60 
to 1.30 Gm.). 

Troehisei Mentha^ Piperita^. 

Aqua Mentha^ Viridis. Used as a vehicle. 

Oleum Mentha^ Viridis. Dose, gtt. iij-x (.20 to 
.60 Gm.). 

Spiritus Mentha^ Viridis. Dose, gtt. x-xx (.60 to 
1.30 Gm.). 

Peppermint and spearmint are favorite stimulant stom- 
achics, and are much used as vehicles in mixtures. The 
troches of peppermint are a popular carminative. The oil of 
peppermint is used sometimes as a counter-irritant in neural- 
gia, following the Chinese practice.] 



MEZEREUM—MEZEREON. 

[ The baric of Daphne Mezereum and of Daphne Gnidium, U. S. 

Officinal Preparations, U. S. 

Decoctum Sarsaparill® Compositum. Dose, 
f^iij-iv (96. to 128. Gm.). 

Extraetum Mezerei Fluidum (used in Ung. 
Mezerei). 

Extraetum Sarsaparillffi Compositum Flui- 
dum. Dose, 3ss-j (2. to 4. Gm.). 

Unguentum Mezerei (a stimulant dressing).] 

This drug is never used save as a constituent of the de- 
coctum sarsaparillie co. 



310 HORSEMINT — MUSK. 

[Misturae. 

The officinal Mixtures are — 

Mistura Ammoniaci Mistura Cretae 

" Amygdalae " Ferri Composita 

ft Assafoetidae u Glycyrrliizae Composita 

" Chloroformi " Potassii Citratis.] 



[MONARD A— HORSEMINT. 

The leaves and tops of Monarda punctata, U. S. 

Officinal Preparation, U. S. 
Oleum Monardae. Dose, gtt. ij-iij (.12 to .20 Gm.). 

Effects and Uses. 

The oil is used in domestic practice for sick stomach and 
flatulent colic ; like the other mints, it is stimulant and car- 
minative. Applied to the skin it is rubefacient, even vesi- 
cant, and has been employed as counter-irritant in chronic 
rheumatism, infantile paralysis, and in low fevers.~\ 



[MOSCHUS— MUSK. 

A peculiar, concrete substance obtained from Moschus Moschiferus, U. S. 

Internal Effects. 

Has undoubted antispasmodic powers, but has been almost 
entirely discarded on account of its high price and frequent 
adulteration. It may be given in doses of gr. v-xv (.30 to 
1. Gm.), in hysterical convulsions, hiccough, in low fevers 
and delirium tremens. An efficient substitute for musk is 
Castoreum, see page 189.] 



[Mucilagines. 

The officinal Mucilages are — 

Mucilago Acaciae Mucilago Tragacantliae 

" Sassafras Medullas " Ulmi.J 



NUTMEG — MYRRH. 311 



MYRISTICA— NUTMEG. 

[The kernel of the fruit of Myristica fragrans (Houttuyn, Nat. Hist.), 

U. S. 

Officinal Preparations, U. S. 

Spiritus Myristieae. Dose, f^j (4. Gm.). 
Oleum Myristieae. Volatile Oil of Nutmegs. Dose, 
gtt. ij-iij (.12 to .20 Gm.).] 



MACIS— MACE. 

The aryllus of the fruit of Myristica fragrans (Houttuyn, Nat. Hist.), 

u. s. 

Enters into Acetum Opii, Pulvis Aromaticus, Spiritus 
Amraonise Aromaticus, Spiritus Lavandulae Compositus, 
Spiritus Rhei Aromaticus, Trocliisci Cretan, Trochisci Mag- 
nesias, and Trochisci Sodii Bicarbonatis.] 

Nutmeg is rarely used in medicine save as a flavoring in- 
gredient. [The dose of Nutmeg or Mace in substance is 
gr. xv (1. Gm.). With its aromatic qualities, nutmeg unites 
considerable narcotic power, and in doses of 5ij-iij (8. to 12. 
Gm.) has produced stupor and delirium.] 



MYRRHA— MYRRH. 

\_A gum-resinous exudation from Balsamodendron Myrrha (Nees, 
Beschreib. Officinel. Pflanzen), U. S. 

Dose, in substance, gr. x-xxx (.65 to 2. Gm.). 

Officinal Preparations, U. S. 

Tinetura Myrrhae (siss to Oj). Dose, f3ss-j (2. to 
4. Gm.). 

Tinetura Aloes et Myrrhae. Dose, f 3j-ij (4. to 
8. Gm.). 

Pilulae Aloes et Myrrhae. Rufus's pills. 

Also enters into Mistura Ferri Composita, Piluke Ferri 
Composite, Pilulge Galbani Composite, and Pilule Rhei 
Compositse.] 



312 



MYRRH. 



Local Uses. 



Physiological. 



Myrrh is astringent, and 
checks excessive secretion 
from mucous surfaces. 



Therapeutical. 



It is a useful addition to 
gargles in relaxed or ulcer- 
ated conditions of the throat ; 
it is a good application to 
spongy or unhealthy gums, 
as in mercurial salivation ; 
and it often forms one of the 
active constituents of lotions 
for foul ulcers, where it gently 
stimulates the granulating 
surface, and corrects the 
fetor of discharges. 



Internal Uses. 



Like all the gum balsams 
and resinous substances, 
myrrh may possess in some 
degree the power of stimu- 
lating mucous surfaces. Tra- 
dition and the habit of pre- 
scribers have also invested it 
with some supposed influ- 
ence over the uterus ; but no 
trustworthy evidence has ever 
been brought forward on this 
point, and it is more than 
probable that its emmena- 
gogue influence is quite secon- 
dary to the other drugs in 
combination with which it is 
prescribed in these cases. 

R. Aluminis 

Tincturse myrrhse 
Infusi rosse comp. 

Misce, fiat srarsrarisma. 



Myrrh has occasionally 
been used as a stimulant in 
chronic bronchitis, but prac- 
tically its application in medi- 
cine is now restricted to the 
administration of the various 
forms of pill in amenorrhea ; 
and here it is impossible to 
separate its action from the 
aloes with which it is invari- 
ably combined. 



3ij ; 
f m ; 

ad f £x ; 



or 



320 



Gm. 



BEBEERU BARK — NUX VOMICA. 313 

NECTANDRA— BEBEERU BARK. 

[The bark of Nectandra Rodiei (Schomburgh), U. S.~] 

The bebeeru bark possesses some of the physiological 
properties of quinine. Thus it arrests the movements of the 
white blood-corpuscles, and checks the development of bac- 
teria ; but unfortunately it does not in any way fulfil the 
same therapeutical indications, save acting as a tonic in 
virtue of its bitterness. 

[Like cinchona, it contains several alkaloids, the principal 
one having received the name of beberia, a sulphate of which 
is officinal in the Ph. Br., but not officinal in the United 
States. The antiperiodic dose of the sulphate of beberia is 
gr. xx-5j (1.30 to 4. Gm.). (It should not be confounded 
with berberina, the active principle of the simple bitters.)] 



NUX VOMICA— NUX VOMICA. 

[ The seed of Strychnos Nux Vomica, U. S. 
Officinal Preparations, U. S. 

Tinetura Nueis Vomicae (^iv-Oj). Dose, n^x 
(.65 Gm.). 

Extraetum Nueis Vomicae. Dose, gr. \ to i 
(.015 to .03 Gm.). 

Strychnia and Stryehnise Sulphas. Dose, gr. 
3*0 t0 T2 (- 002 to - 005 Gm.).] 

Poisonous Effects. 

Strychnia kills by inducing hyper-excitability of the reflex 
functions of the spine, with violent tetanic spasms, leading 
to death by exhaustion or suffocation. The fatal event may 
take place in a few minutes if the close be a large one, and 
the minimum quantity required to destroy life is about half 
a grain. Contrary to the habit of other poisonous drugs, 
strychnia acts most rapidly and efficiently when given by 
the rectum. 

Antidotes. 

In a case of strychnia-poisoning, we may first administer 
tannin, which places the drug in an insoluble form, then, 
after evacuation of the stomach, it will be necessary to try 
21 



314 NUX VOMICA. 

the physiological antidotes. These are chloral, bromide of 
potassium, Calabar bean, and nicotia [or tobacco enemata], 
although the use of the last-mentioned remedy must be con- 
ducted with extreme caution. Finally, we may have recourse 
to artificial respiration. 

[Tests. 

Strychnia may be recognized by rubbing a small por- 
tion with a few drops of sulphuric acid, containing one-hun- 
dredth of its weight of nitric acid. No change ensues ; but 
the addition of a very small quantity of the peroxide of lead, 
or of bichromate of potassium, changes the solution to a blue 
color, then to a red, and in the course of a few hours to a 
yellow color. Commercial strychnia sometimes affords a red 
color, changing to a yellow, with nitric acid, owing to the 
presence of brucia. 

Brucia is colored red by nitric acid, and this color 
changes to violet by the addition of protochloride of tin. 
With chlorine it gives a red color. Sulphuric acid first 
reddens brucia, and then turns it yellow and green.] 

Local Action. 
No special local action has been noted. 

Constitutional Action. 

1. B 7- ain and Nervous Sys- 1. Nux vomica, and more 
tern — No effect is produced especially strychnia, are ex- 
on the brain, the cerebral cellent nervine tonics, acting 
functions remaining unim- well in simple debility, ner- 
paired almost up to the close vous exhaustion, and inconti- 
of a case of strychnia-poison- nence of urine, and promot- 
ing, ing the return of function 

The spinal cord, however, after some forms of paralysis, 

is early attacked, and violent When all inflammatory 

and distressing tetanic spasms symptoms have subsided, 

prove the irritating influence strychnia may be prescribed 

of the drug, more especially in the hope of stimulating the 

on the reflex excitability of spine to resume its duties, 

that organ. and restoring tone to mus- 

In large doses, strychnia cles which long remained 

also paralyzes the efferent in a state of inactivity. Thus, 

(motor) nerves, causing loss in paraplegia, hemiplegia, 



NUX VOMICA. 



315 



of power of voluntary move- 
ment. 

The vasomotor and proba- 
bly the respiratory centre are 
stimulated. 



2. Heart and Circulation. 
— Strychnia causes rise of 
arterial pressure and con- 
traction of the capillaries. 
Strychnia is an excellent 
remedy in some cases of 
paralytic and emphysematous 
asthma. 

3. Respiration and Tem- 
perature. — The interference 
with breathing observed in 
strychnia - poisoning, and 
which usually terminates the 
life of the victim, is due to 
spasmodic fixation of the 
diaphragm and respiratory 
muscles. 

4. Digestive and Secreting 
Organs. — Strychnia has a 
tonic influence over the di- 
gestive process, aiding oxida- 
tion, removing the products 



diphtheritic paralysis, and 
wrist-drop, strychnia may 
well go hand in hand with 
galvanism when all evidence 
of irritation of the nervous 
structures has completely 
disappeared. Mr. Barwell 
has proposed subcutaneous 
injections of strychnia in in- 
fantile paralysis, using a 
large dose ( T ^ to T \ gi\, 
.005 Gm.), and forcing the 
fluid freely into the muscular 
structures. [To begin with, 
a much smaller dose should 
be exhibited. One-half a 
grain, by the mouth, has 
killed an adult.] 

In chorea it has been 
highly praised by Trousseau, 
Hammond, and others. 



4. Strychnia, and more 
especially mix vomica, are 
excellent tonics, improving 
the appetite in a marked 



degree 



but, in addition to 



316 



NUX VOMICA. 



of waste, and delaying putre- 
faction. 



this, nux vomica is of great 
service in various dyspeptic 
conditions, relieving heart- 
hum, nausea, and flatulence, 
and being also a reliable 
remedy in sick headache and 
the vomiting of pregnancy. 
It is an excellent addition to 
purgative pill masses, improv- 
ing the tone of the muscular 
wall of the intestines and re- 
lieving constipation. 



Dose, Mode of Administration, etc. 

The dose of strychnia may be put at from -^L to y 1 ^ gr. 
(.002 to .005 Gm.), and the liquor [Br.] is a convenient 
form, in doses of from 5 to 10 minims, added to any ordinary 
tonic mixture. We are usually advised to suspend its adminis- 
tration from time to time, as it is stated that uncomfortable 
twi tchings and rigidity about the jaw may suddenly arise, 
giving evidence of the so-called "accumulation" of the drug. 

By hypodermic injection we are usually taught that gr. 
t ^q is the proper dose, and it is therefore difficult to under- 
stand why no poisonous results followed BarwelFs somewhat 
heroic medication, the reason probably being that the strych- 
nia has been very imperfectly absorbed. 



I£. Ferri sulph. exsic. gr. xl ; 

Quiniae sulph. gr. xl ; 

Strychnise sulph. gr. ss ; 

Marmae q. s. 

Fiant pilule xx. Sumat unam ter die. 

A useful tonic pill. 

]$. Tinct. nucis vomicae 

Acidi nitro-muriatici diluti 

Spiritus chloroformi 

Infusi gentianse 
S. Dose, f ^j ter die sumend. 

For flatulent colic, taken after meals 



or 



f5.i; 


or 


4 


f 5ij ; 


(< 


8 


±'3j; 


n 


4 


ad f §vj ; 


a 


192 



60 Gm. 
60 " 
03 " 



Gm. 



M. 



M. 



R. Ferri sulph. 








Ext. nucis vomicae 


aagr. ss ; 


or 


03 Gm 


Ext. aloes Barb. 


gr. iij ; 


a 


20 " 


Fiat pil. ante cibum sumend. 








A good " dinner pill." 









M. 



ETHEREAL OIL — COD-LIVER OIL, 



317 



[Olea. 



The officinal Oils are — 

Oleum iEtbereum 

" Amygdalae Amarae 

" " Expressum 

" Anisi 

' ' Bergamii 

" Cajuputi 

" Camphorse 

" Cari 

' ' Caryopbylli 

' ' Clienopodii 

" Cinnamonii 

" Copaiba? 

" Cubebae 

" Erigerontis Canadensis 

" Foeniculi 

' ' Oaultheriae 

" Hedeomae 

" Juniperi 

" Lavandulae 

' ' Limonis 

" Lini 

" Menthae Piperitae 



Oleum Menthae Viridis 

" Monardae 

" Morrhuee 

! { Mvristicae 

" Olivae 

" Origani 

" Pimentse 

" Ricini 

" Rosae 

" Ro-smarini 

" Rutae 

" Sabinae 

" Sassafras 

11 Sesami 

" Succini 

" " Rectificatum 

" Tabaci 

" Terebinthinae 

" Tbeobromae 

" Thymi 

" Tiglii 

" Valerianae.] 



[OLEUM JETHEREUM— ETHEREAL OIL, U. S. 

Heavy oil of wine is a limpid, almost colorless, volatile 
fluid, of a pungent taste and vinous odor. Its solution in 
alcohol and ether is officinal as Spiritus JEtheris Compositus 
(see page 121), but it is never prescribed alone.] 



OLEUM MORRHUA— COD-LIVER OIL. 

[ The fixed oil obtained from the livers of Gadus Morrhua and of other 
species of Gadus, U. S.~] 

Local Action. 

Cod-liver oil is not used in virtue of any local action, as 
its nauseous smell effectually prevents it from forming the 
basis of ointments or liniments. Being very readily ab- 
sorbed by the skin, however, it is occasionally introduced 
into the system by this channel when the patient is unable 
to take it by the mouth. [Inunctions with cod-liver oil are 

27* 



318 



COD-LIVER OIL. 



very useful in cachectic and scrofulous infants. It has also 
been used in ophthalmic practice, instilled into the eye, to 
remove slight opacity of the cornea.] 

Constitutional Actions. 
Physiological. Therapeutical. 

1. Brain and Nervous 1. It is therefore specially 

System Cod-liver oil can indicated in all nervous affec- 

only be said to act on the tions dependent on debility, 

nervous system by improving such as neuralgia, some 

its nutrition and supplying forms of insanity, asthma, 

the fatty ingredients neces- whooping-cough, etc. 

sary for growth and repair. 

2. Circulation It has a 2. It is therefore much 

tonic influence on the circu- used in simple debility, in 

lating organs, by improving convalescence from acute i 11— 

the quality of the blood, in- ness, in ancemia, tertiary 

creasing the number of red syphilis, and other weakened 

blood - corpuscles, both in conditions of the system, 
health and in some patholo- 
gical conditions, if it is well 

borne, and strengthening the 
heart-muscle. 

3. Respiration and Tern- 3. Under this heading we 
perature — No special physi- may place, for convenience, 
ological influence is exerted the wonderfully restorative 
on either of these functions, effects of cod-liver oil in 
[In addition to its value as chronic lung disease, but 
a hydro-carbon in simply more especially in the va- 
nourishing the body, it is rious forms of pulmonary 
alterative by virtue of a small phthisis. It is beneficial in 
proportion of iodine, bro- asthma and chronic bronchi- 
mine, and phosphoric acid tis, but in consumption it 
which it contains, associated really seems to be directly 
with certain biliary princi- curative. It may be given 
pies, in a manner, perhaps, with advantage in all stages, 
best adapted to secure their and under its use patients 
absorption and assimilation.] often rapidly gain flesh, and 

not only manage to hold the 
disease at bay, but even oc- 
casionally seem to escape 
from its clutches. 



COD-LIVER OIL. 



319 



4. Digestive and Secreting 
Organs. — It 1ms been proved 
by experiment that animal 
are much more digestible 
than vegetable oils, probably 
on account of containing bile, 
and cod-liver oil is the most 
readily assimilated of all. 
After being emulsified by the 
pancreatic juice, it comes in 
contact with the bile, which 
distinctly increases its power 
of passing through moist ani- 
mal membranes ; and it is 
probable also that the biliary 
principles incorporated in its 
own structure aid in enabling; 
it to be easily absorbed by 
the lacteals. Its action on 
the system now is to improve 
the general constitutional 
tone, to evolve force and heat, 
and to aid in supplying those 
fatty elements which are so 
essentially requisite for the 
construction and repair of 
the tissues. 

Cod-liver oil occasionally 
causes nausea, vomiting, and 
diarrhoea, and it has been 
shown to increase in some 
measure the biliary secretion. 



4. Cod-liver oil is almost 
invaluable in diseases de- 
pending on defective nutri- 
tion, as in all scrofulous 
conditions, such as strumous 
ophthalmia, caries of bones, 
chronic joint-affections, glan- 
dular enlargements, etc. ; also 
in rickets and all the wasting 
disorders of childhood, in 
senile atrophy and decay, in 
chronic rheumatism, in all 
the ulcerative varieties of 
skin disease, and in advanced 
constitutional syphilis. Va- 
rious attempts have been 
made to explain the actions 
of the oil by means of certain 
special ingredients which it 
contains ; but none of these 
have been successful, and we 
cannot at present do more 
than attribute its restorative 
influence to its ready diges- 
tibility and nutritive proper- 
ties. 



Mode of Elimination. 

The greater part of the oil is absorbed into the system, but 
a little is given off by the feces ; and it is well to watch the 
evacuations of children under its influence, to see whether 
any undigested oil escapes, this indicating an overdose. 

Drawbacks. Mode of Administration. 

Cod-liver oil occasionally produces so much nausea, eruc- 
tation, and discomfort, as to compel us to suspend its admin- 
istration ; but most patients, and more especially children, 



320 COD-LIVER OIL. 

speedily grow accustomed to its use. An eruption of acne 
sometimes is caused by the passage through the cutaneous 
glands of some of its acrid constituents. It is advisable to 
prescribe it in small doses directly, or, even better, an hour 
after meals, or at bed-time, to give it with some light tonic, 
and to suspend it from time to time, more especially in hot 
weather or when bilious symptoms supervene. It may well 
be given in combination with a little alcohol, beaten up with 
the froth of porter, with mucilage, or lemon-juice, or with 
from n^x to f'5j of aether puris, which, Dr. B. Foster tells 
us, and which I have amply confirmed by experience, aids 
digestion by stimulating the pancreatic secretion ; but if the 
pale oil is used, very few persons will be found entirely re- 
bellious to its use. Children, as a rule, take it well, but if 
they prove obstinate we may give it with orange wine, or in 
the following combination : — 



H- Olei morrhuae f§ss; or 16 

Mucilaginis acaciae f §ij ; " 64 

Sacchari ^ij ; " 8 

Spiritus lavandulae comp. v\xx ; " 1 

Aqua3 ffss; " 16 
f t :$ss pro dosi. 



Gm. 



30 



M. 



[In private practice, Dr. Foster prefers to give the follow- 
ing mixture: — 

R. Potassce bicarb. 5.) ss- ij ! or 6 Gm. 

Acidi liydrocyan. dil. TT^xij-xvj ; " 75 " 

Spt. aetheris ^jss — iij ; " 6 " 

Aquae ad 3viij ; " 256 " M. 

Dose |j ter in die sumat.] 1 

Black coffee forms a good medium for adults, or we may give 
the oil floating on beer, porter, or on the following mixture : — 

U. Acidi nitrici diluti 

Acidi hydrocyanici dilut, 

Tincturae aurantii 

Aqiue f|ss;' " 16 " M. 

The dose should never exceed half an ounce. 

[A pancreatic emulsion of cod-liver oil, and an emulsion 
with the lacto-phosphate of lime, or one with lime-water 
flavored with oil of bitter almonds, are largely used for 
children, although not officinal. Equal parts of extract of 
malt and cod-liver oil make a mixture that is readily taken 
by children.] 

1 [Fothergill's Handbook of Treatment, Pliila , 1878.] 



m*; 


or 




65 


Gn 


mj-ij ; 


i i 




06 


n 


f £ss ; 


u 


2 




a 


f ?ss ; 


i i 


16 




a 



OLIVE OIL — CASTOR OIL. 321 

OLEUM OLIVJE— OLIYE OIL. 

[The fixed oil obtained from Olea Europoza, U. S. 

Olive oil is nutritious and laxative, and is occasionally 
used for children as a substitute for castor oil. Dose, for an 
adult, fgij-iv (64. to 128. Gm.). It is a useful remedy for 
all kinds of irritant poisoning except phosphorus in sub- 
stance. It is used largely in pharmacy.] 

Olive oil is only used externally as an emollient applica- 
tion, and as the basis of various liniments. 



OLEUM RICINI— CASTOR OIL. 

[The fixed oil obtained from the seeds of Ricinus communis, U. S. 

Enters into the Officinal Preparations, Collodium cum 
Cantharide and Collodium Flexile.] 

External Uses. 

Castor oil is a substance of such bland and unstimulating 
quality, that, were its smell less offensive, it might form a 
valuable external agent in certain cases. It is, however, 
occasionally used as a soothing application to the eye when 
extreme temporary irritation has been set up by abrasion of 
the corneal epithelium. Castor oil will purge when rubbed 
into the skin. 

Internal Uses. % 
Physiological. Therapeutical. 

Castor oil gently stimulates Castor oil is a mild and 

the peristaltic movements of efficient cathartic, emptying 

the intestinal canal, and the intestines without causing 

slightly augments the fluid griping or discomfort. It is 

secretions of the gut. Some therefore useful in all cases 

amount of astringent action where we simply wish to un- 

generally follows the purga- load the bowels ; but it is not 

tive action of the drug. a good habitual purgative 

The seeds are very irri- from the subsequent constipa- 

tating, and cause gastro- tion produced. This astrin- 

intestinal irritation, three gent action, however, gives it 

having proved fatal to an a special advantage in the 

adult. treatment of diarrhoea, many 



322 OIL OF AMBER. 

cases of which depend on 
the presence of irritating 
matters in the intestinal 
canal; and under such cir- 
cumstances, common sense 
naturally indicates the pro- 
priety of expelling the excit- 
ing cause. Dr. Geo. John- 
son, however, goes further 
than this, and advocates the 
kt eliminative" treatment of 
all diarrhoeas, as well as of 
cholera. 

Dose and Mode of Administration. 

Although the best castor oil has but little actual flavor, it 
leaves a greasy, sickly sensation on the palate, which is ex- 
ceedingly unpleasant. It is therefore important to give it in 
some form of combination, and we find floating the dose in a 
glass between two strata of whiskey or brandy [and cinnamon 
water] to be an effectual plan, or we may make use of the 
following formulae : — 

R. 01. ricini 

Mucilaginis acaciae, 

Syrupi simplicis, 

Aqnse cinnamomi ad f.lii ; 64 M. 

Fiat haustus statim sumendus. 

R. 01. ricini 
Tinot. opii 
Syrupi zingiberis 

Aquse menth. pip. ad f 5 ij ; "64 " M. 

Fiat haustus statim sumendus. 

Either makes a good prescription for the diarrhoea of irri- 
tation. 



f*ss ; 


or 


16 


Gm. 


aa i'5ij ; 


<< 


8 


a 


ad fgij ; 
lus. 


it 


64 


a 


f <?iij ; 

f 5J ; 

ad f i ii ; 


or 

a 
a 


12 

4 
64 


Gm 
65 " 

a 
a 



[OLEUM SUCCINI— OIL OF AMBER. 

The volatile liquid obtained by the destructive distillation of amber, U. S. 

Officinal Preparation, U. S. 

Oleum Suceini Reetificatum. Rectified oil of 
amber. Dose, gtt. x-xx (.65 to 1.30 Gm.). 

The oil of amber is stimulant and antispasmodic, and has 
been recommended in bronchitis, hysteria, and obstinate hie- 



CACAO BUTTER — CROTON OIL. 



323 



cough, and is also used externally, diluted with sweet oil, as 
a sedative and rubefacient for whooping-cough, or for in- 
fantile convulsions, as in the mixture recommended by Dr. 
Jos. Parrish : — 



R. Olei succini rectificati, 

Tincturse opii, aa f§ss 

Olei olivae, 

Spiritus vini Gallici, aa f^ij ; 
Fiat lotio. 

To be rubbed along the spine.] 



or 



16 
64 



Gm. 



M. 



OLEUM THEOBROM.E— CACAO BUTTER. 

[The concrete oil of the kernels of the fruit of Theobroma Cacao, U. S.~\ 

Oil of theobroma, being a firm, solid, and agreeable sub- 
stance, is much used in the manufacture of suppositories, and 
enters into — 

Suppositoria Acidi Carbolici each gr. j of carbolic acid. 



Taimici 
Aloes 

Assafcetidse 
Belladonna? 
Morj)hia3 
Opii 
Plumbi 
Plumbi et Opii 



gr. v of tannic acid. 
gr. v of purified aloes, 
gr. v of assafetida. 
gr. ^ extract of belladonna, 
gr. ^ sulphate of morphia, 
gr. j extract of opium, 
gr. iij plumbi acetatis. 
gr. iij plumbi acetatis and 
gr. ^ extract, opii.] 



[OLEUM THYMI— OIL OF THYME. 

The volatile oil obtained from Thymus vulgaris, U. S. 

The oil of thyme is said to furnish the greater part of the 
commercial oil of origanum. It is aromatic and counter- 
irritant, the oil being used almost exclusively as a local ap- 
plication, and as an ingredient in opodeldoc, the linimentum 
saponis camphoratum of former editions of the Pharmaco- 
poeia.] 



OLEUM TIGLII— CROTON OIL. 

[ The fixed oil obtained from the seed of Croton Tiglium, TJ. S. 
Dose gtt. i-iv (.06 to .25 Gm.).] 



324 



CROTON OIL. 



Local Action. 



Physiological. 

The topical application of 
croton oil to the skin causes 
a good deal of irritation, fol- 
lowed by the appearance of 
a copious crop of papules, 
gradually developing into pus- 
tules. Dr. Tilbury Fox has 
described a symmetrical ery- 
thema of the face following 
this local employment ; and 
it is said that the addition of 
an alkali favors the develop- 
ment of the counter-irritant 
properties of the drug. 



Therapeutical. 

The local application of 
liniments containing croton 
oil was in former years a fa- 
vorite mode of using counter- 
irritation in various chronic 
lung-affections, and it is still 
employed, more especially in 
public practice. But its draw- 
backs are, that it has a ten- 
dency to overact on tender or 
irritable skins, and the pus- 
tules are liable to leave cica- ' 
trices, so that it is difficult to 
believe it in any way superior 
to other and milder applica- 
tions. 



Internal Action. 



When taken internally, 
croton oil produces much irri- 
tation of the intestines, run- 
ning on, if the dose be suffi- 
ciently large, into a very fair 
imitation of the symptoms of 
cholera-poisoning, with vom- 
iting, extreme purging, col- 
lapse, and acute inflammation 
of the intestines. 



Croton oil, then, is a dras- 
tic purgative, valuable in cer- 
tain cases on account of its 
rapid and powerful action. 
Thus in apoplexy and other 
cerebral affections, where it 
is of importance to obtain an 
immediate and thorough evac- 
uation of the bowels, and in 
some conditions of obstinate 
constipation, we find con- 
siderable advantage from its 
cautious use. 



Mode of Administration, etc. 

Croton oil has an acrid and irritating flavor, and is best 
given in the form of pill or rubbed up with sugar. Garrod, 
however, tells us that it may well be prescribed in combina- 
tion with castor oil, and, in case the patient is unable to swal- 
low, it may be placed on the back of the tongue. 

In an extreme case we might expect to obtain some purga- 



opium. 325 

tive effect from rubbing it into the skin, as it appears to act 
by absorption through this channel. 

R. Olei crotonis Ti\ij ; or 12 Ghn. 

Mica? panis q. s. M. 

Fiat pilula, statirn sumenda, et horis duabus repetenda 
si opus sit. 

Or we may endeavor to keep its irritating properties in 
check by prescribing it in the following combination : — 

R. 01. crotonis THirj or 

Ext. colocynth. comp. gr. xx; u 

Ext. belladonnse gr. iij ; " 

Misce, divide in pil. vj, quarum suniat unam si opus sit. 

For external use, a very good liniment is contained in the 
British Pharmacopoeia. 



20 Gm. 
30 " 

20 " 



OPIUM—OPIUM. 

[ The concrete juice obtained from, the unripe capsules of Papaver som- 
niferum, by incision and spontaneous evaporation, U. S. 

Dose, gr. j (.06 Gm.). 

Officinal Preparations, U. S. 

Aeetum Opii (gr. j in n^viss), Black drop. Dose, 
n^v-vij (.30 to .45 Gm.). 

Confeetio Opii (gr. 1 in 36). Dose, 5ss (2. Gm.). 

Extraetum Opii (double strength of opium). Dose, 
gr. ss (.03 Gm.). 

Emplastrum Opii (extract 1 in 16). 

Suppositoria Opii (extract of opium gr. ss). 

Suppositoria Plumbi et Opii (plumb, acet. gr. iij ; 
extr. opium gr. ss). 

Pilulas Opii (each gr. j). 

Pilula Saponis Composita (mass 20 per cent, 
opium). 

Pulvis Ipecacuanhas Compositus (Dover's Pow- 
der, gr. 1 in 10). Dose, gr. x (.65 Gm.). 

Tinctura Opii (gr. j in n^xiij). Dose, n^xiij (.80 
Gm.). 

Tinctura Opii Acetata. (gr. j in n^x). Dose, n^x 
(.65 Gm.) 

Tinctura Opii Camphorata (gr. j in f^ss). Dose, 
f3j to iv (4. to 16. Gm.). 
28 



326 opium. 

Tinetura Opii Dedorata (gr. j in rr^xiij). Dose, 
T^xiij (.80 Gm.). 
Troehisei Glycyrrhizas et Opii (gr. 1 in 20). 
Troehisei Morphias et Ipecacuanhas (each gr.^). 
Liquor Morphias Sulphatis (gr. j in f'gj). Dose, 
f3j (4. Gm.). 

Suppositoria Morphias (each, gr. ss). 

Virium Opii (gr. i in n^viij). Dose, n^viij (.50 Gm.). 

(Morphias Aeetas ) n l , 

Morphia Morphias Murias V f ^T' Jf'r. T ^ 

^Morphias Sulphas) (° 06 t0 ° 3 Gm '^ 

Poisonous Action. 

When opium has been given in a poisonous dose, the re- 
sulting sleep gradually grows deeper, the breathing becomes 
heavy and stertorous, the face is flushed, swollen, and dusky, 
the pupils contracted to mere points, distension of the right 
side of the heart still further prevents the return of blood 
from the engorged lungs, and paralysis of the respiratory 
centre finally causes death by suffocation. Much difficulty 
may occasionally attend the diagnosis of opium-poisoning 
from (1) alcoholic coma, where, however, the pupils are 
usually dilated; (2) from uroemic coma, where an examina- 
tion of the urine, if practicable, might clear up our doubts ; 
and (3) from apoplectic effusion in the pons Varolii, where 
the symptoms are usually so similar as to render an absolute 
diagnosis, under certain circumstances, impossible. After 
death we find well-marked congestion of the brain. 

Treatment and Antidotes. 

When summoned to a case of opium poisoning, the first 
indication must be to evacuate the stomach, and this is best 
effected by the stomach-pump, as the vomiting centre is too 
much paralyzed by narcosis to allow of its effective stimula- 
tion by emetics. We then try to counteract the tendency to 
sleep by cold affusion, irritation of the skin, strong coffee, 
galvanism, and walking the patient about, and, finally, we 
may cautiously use atropine as the physiological antidote. 
Although some good evidence comes to us from China of 
opium-poisoning checked by the antagonistic action of atro- 
pine, reports and opinions differ much on this head, and some 



OPIUM. 



327 



authorities hold that atropine in certain proportions may 
even intensify the action of morphia. 

Professor Bennett believes that atropia may be of service 
by contracting the vessels of the brain, and limiting the ten- 
dency to cerebral congestion. 

As a last resource, we may have recourse to artificial 
respiration. 



Local Action. 



Physiological. 



It seems very doubtful 
whether opium can be ab- 
sorbed through the unbroken 
cuticle. We are told that 
opium inspectors in India 
will remain for hours with 
their arms plunged up to the 
elbows in the inspissated ex- 
tract, and that no narcotic 
effect is produced ; but it is 
difficult, on the other hand, 
to believe that opium is en- 
tirely devoid of a property 
which belladonna possesses 
in so remarkable a degree. 
Sir Henry Thompson is also 
strongly of opinion that the 
bladder cannot absorb opium. 



Therapeutical. 

Fomentations with the de- 
coction of poppy-heads, and 
with other preparations of 
opium, have long been re- 
cognized as efficient means 
for the relief of pain in vari- 
ous inflammatory conditions, 
as hemorrhoids, erysipelas, 
conjunctivitis, etc. ; but as 
we cannot bring forward evi- 
dence of absorption of the 
drug, we must merely attrib- 
ute this soothing influence to 
the thorough application of 
moist heat. 



Internal Actions. 



I. On Nervous System — 
1. Brain In small quan- 
tity, or temporarily as the 
occasional preliminary action 
of a truly narcotic dose, 
opium is gently exciting to 
the brain, the intellectual 
faculties becoming generally 
stimulated, and the imagina- 
tion more vivid. To this, 
however, rapidly succeeds a 
dulling or deadening effect, 



I 1. Opium, being the 

most certain narcotic known, 
is very largely prescribed in 
a great variety of cases. In 
simple insomnia, in worn-out 
conditions of the nervous 
system, in acute fevers, such 
as typhus and typhoid, where 
delirium and sleeplessness 
constitute truly dangerous 
complications, in delirium 
tremens, in the later stages of 



328 



OPIUM. 



drowsiness supervenes, and 
deep sleep finally sets in, 
from which the patient wakes 
within a period of time pro- 
portioned to the quantity of 
the drug administered. Head- 
ache, dryness of the mouth, 
and digestive disturbance are 
frequently experienced, and 
idiosyncrasy may in some rare 
cases interfere materially with 
sleep by bringing into special 
prominence the exciting or 
stimulating properties of 
opium. It is not quite clear 
in what precise way the nar- 
cotizing influence is in this 
instance produced ; but analy- 
sis would lead us to believe 
that contraction of the cere- 
bral vessels imitates natural 
sleep by inducing an annemic 
condition of the gray matter 
of the brain. This has been 
proved by the experiment of 
Hammond, who found that 
the brain is anaemic in sleep 
caused by a small dose, but, 
as the sleep passes into coma, 
after a large dose, venous 
congestion sets in. The re- 
suiting contraction of the 
pupil is probably central in 
origin, as it cannot be pro- 
duced by any local applica- 
tion of opium in any form. 

2. The conductivity and 
irritability of the sensory 
nerves are much diminished, 
so that pain is felt with less 
intensity. 



severe smallpox, in menin- 
gitis, acute mania, and in 
numerous other diseased con- 
ditions, which the reader can 
readily recall, this invaluable 
drug does most essential ser- 
vice by procuring sound and 
refreshing sleep. 



2. And even when not 
given in truly narcotic doses, 
it may also lull the sufferer 
into slumber by benumbing 
the sensory nerves and re- 
moving pain. As a sedative, 



OPIUM. 



329 



3. The reflex function of 
the spinal cord is at first 
slightly increased, but subse- 
quently becomes lessened in 
degree, and the respiratory 
centre is weakened and finally 
paralyzed. In cold-blooded 
animals, as the frog, in which 
the cerebral are subordinated 
to the spinal functions, opium 
causes most violent tetanic 
convulsions. [This also hap- 
pens occasionally in children.] 



4. The sympathetic system 
of nerves is also primarily 



anodyne, or analgesic, it is 
indispensable in many pain- 
ful conditions, such as neu- 
ralgia, sciatica, cancer, bili- 
ary or renal calculi, labor 
after-pains* colic, etc., and, 
as we shall presently see, 
the subcutaneous injection of 
morphia is the most effectual, 
as it certainly is the most 
rapid and convenient, mode 
of obtaining this action of 
the drug. 

Opium is also an excellent 
antispasmodic, and acts well 
by relieving irregular mus- 
cular contraction, as in the 
intestine causing colic, in the 
uterus tending to abortion, 
or exhausting after-pains, in 
spasmodic urethral stricture; 
and its remarkable influence 
over some forms of obstinate 
ulceration must also be due to 
some nervous influence. 

3. Opium, having the pro- 
perty of arresting the mus- 
cular action of various organs, 
is our sheet-anchor in those 
terrible cases where rupture 
of the intestine, bladder, or 
uterus, has occurred, and 
where the only possible 
chance of recovery consists 
in most perfect rest of the 
viscera, encouraging the heal- 
ing process, and preventing 
the escape of irritating se- 
cretions into the peritoneal 
cavity. 



28* 



330 



OPIUM. 



excited and secondarily de- 
pressed. 

II. Vascular System. — 
The action of the heart is at 
first slightly quickened, but 
afterwards its beats become 
slower, the pulse fuller and 
firmer, and the arterial ten- 
sion raised, this effect being 
considered due to an influ- 
ence on the cardiac inhibi- 
tory nerves. It is noted, 
however, that shortly before 
death, in cases of opium-poi- 
soning, the pulse becomes 
feeble, rapid, and irregular. 
The stimulating action on 
the sympathetic nerves causes 
some contraction of the 
smaller vessels to accompany 
the use of moderate doses of 
opium. 

III. Respiration and Tem- 
perature. — The breathing 
tends to become slow from 
the paralyzing influence of 
opium on the . respiratory 
centre, and at the same time 
the secretion from the bron- 
chial tubes is lessened. 

The temperature at first 
rises a little, but finally falls 
when sweating - is established. 



IV. Digestive and Secret- 
ing Organs. — 1. Nausea oc- 
casionally follows the use of 



II. The subcutaneous in- 
jection of morphia has been 
advised by Dr. Clifford All- 
butt in angina pectoris, pal- 
pitation, and various painful 
cardiac conditions. Its con- 
tracting influence on the 
small vessels explains the 
antiphlogistic effect of opium 
in cases of peritonitis and 
other inflammatory condi- 
tions, as well as its power of 
checking coryza in its early 
stage. It also acts well as 
an astringent in some forms 
of hemorrhage, and more es- 
pecially that from the lungs. 



III. Opium is the most 
soothing remedy for coughs 
of all kinds, but more espe- 
cially that of phthisis. It is 
a valuable aid in spasmodic 
asthma and the early stages 
of acute pneumonia, but in 
the later stages Ave must be- 
ware of its power of checking 
secretion, and in bronchitis 
it may do harm by slowing 
the respiratory movements, 
causing sleep to interfere with 
the due emptying of the bron- 
chial tubes, and thus leading 
on to imperfect aeration of 
the blood and final suffoca- 
tion. 

IV 1. Opium is an ex- 
cellent astringent in diar- 
rhoza, dysentery, and British 



OPIUM. 



331 



opium, and constipation in- 
variably results from diminu- 
tion of the intestinal secre- 
tions, no less than arrest of 
the peristaltic movements of 
the canal. 



2. The salivary secretion 
is also diminished, causing 
dryness of the tongue. 

3. The urine is lessened 
in quantity, but opinions 
differ as to the effect pro- 
duced on , its solid ingredi- 
ents. 



4. The biliary secretion is 
checked. 

5. The secretion of the 
skin is increased, perspira- 
tion generally resulting, and 
we may say generally that 
opium checks all secretions 
but that of the skin. Elimi- 
nation takes place by the 
breath, sweat, urine, etc. 



[or sporadic] cholera, often 
succeeding where other re- 
medies fail, and for the re- 
lief of pain and tenesmus, 
nothing is better than the 
enema of the [Br.] Pharma- 
coposia. In the diarrhoea of 
ulcerative processes, such as 
typhoid and phthisis, and the 
later stages of dysentery, it 
is truly invaluable. 



3. Opium is of great ser- 
vice in some cases of diabetes, 
checking the craving appe- 
tite, and lessening the secre- 
tion of sugar. 

We must beware of its use, 
however, in advanced cases 
of renal disease, where it 
acts injuriously by checking 
secretion and encouraging 
the retention of urea in the 
blood. 



5. Opium in some forms, 
but more especially Dover's 
powder, acts as an efficient 
diaphoretic. 



Cautions and Modes of Administration. 

In giving opium we must remember that human beings, 
like the lower animals, are diversely susceptible to its in- 
fluence. Thus ducks and pigeons can swallow large quanti- 
ties with impunity, whilst the horse and the dog rapidly fall 



332 opium. 

under its influence ; and although we can hardly lay down 
any general rules to guide us in practice, we shall find that 
some persons can take very heavy doses, whilst others are 
poisonously affected with unexpected rapidity. We must 
specially remember that children always bear opium badly, 
one drop of laudanum having proved fatal to an infant ; that 
anamiic persons also are said by Traube to be readily sus- 
ceptible. To guard ourselves as far as possible from risk, 
we shall do well to begin with a moderate dose, and invari- 
ably to ask our patient whether he has ever taken it before. 

As the system seems rapidly to accustom itself to the use 
of opium, we require gradually to increase the dose, and so 
completely do persons habituate themselves to the pleasurable 
sensations derived, that they willingly brave the resulting 
languor and digestive disturbance, and take it in enormous 
quantities. De Quinceyused to take as much as 320 grains 
daily, and from half a pint to a pint of laudanum is by no 
means an uncommon daily allowance. Although the Turks 
and Chinese are the principal victims 'of this habit, much 
opium is also consumed in this way in some parts of Eng- 
land, and moderate opium-eaters abound in all ranks of 
society. We must therefore be very careful to warn our 
patients from time to time of the absorbing nature of this 
practice, and of its enervating effects on mind and body ; and 
although it seems evident that continued good health is 
altogether incompatible with even moderate opium- eating, 
and that its use by smoking is far more deleterious, still 
there is abundant evidence of the generally lowering ten- 
dency of the habitual use of this drug as an act of mere self- 
indulgence. 

As regards the various pharmaceutical preparations of 
opium, when we wish to produce sleep w r e generally prescribe 
the tincture in a medium dose, the pil. saponis co., or the 
extract ; whereas, if we merely wish to relieve pain, smaller 
doses may prove sufficient. 

The astringent action is best secured by small doses, which 
bring the stimulant properties of the drug into play ; and an 
incipient coryza may often be checked by 5 or 10 minims of 
laudanum, taken at bed-time. 

For diaphoretic purposes the combination with ipecacu- 
anha, as in Dover's powder (pulvis ipecacuanha? compositus), 
is of service; and, for the relief of diarrhoea, we also call to 
our aid the astringent properties of chalk and kino, as in the 



R. Syrupi scillse 


f.^ij; 


or 


64 


Aq. menth. pip. 


f§ij; 


i i 


64 


Tine, opii ammoniatas [Br.] 


f|ss ; 


i c 


16 


Spiritus lavandulse comp. 


f t ;ss ; 


i i 


16 


Syrupi 




a 


32 


Dose, f £ss ter die. 









opium. 333 

pulvis cretce aromaticus cum opio [Br.], and the pulvis kino 
compositus [Br.]; or the enema opii [Br ] maybe soothing, 
both in this condition and as allaying, by nervous sympathy, 
various painful conditions of the uterus and bladder. 

As an adjunct to cough mixtures, and as forming their 
really effective ingredient, we most conveniently prescribe 
opium under the form of either the tinctura camphors com- 
posita or of the tinctura opii ammoniata [Br.], as in Prof. 
Christison's well-known formula : — 

Gm. 



M. 



In diabetes we may push the drug boldly, to the extent 
even of from 6 to 8 grains a clay. 

The many-sided actions of opium, which we have just de- 
scribed, are due to its complex constitution and to the large 
number of alkaloids which it contains. Of these, morphia is 
by far the most generally used, and in the form either of 
sulphate, the muriate, or the acetate, but more especially of 
the former, it has in very considerable measure superseded 
the crude drug, on which we were formerly obliged to de- 
pend. Its principal differences from opium are as follows : — 

It is less astringent and antiphlogistic, and, interfering 
less with secretion, its use is not attended by so much head- 
ache, constipation, and dryness of tongue. It is more directly 
narcotic and anodyne, and is therefore a more convenient 
remedy when we wish merely to promote sleep or relieve 
pain. 

Its bulk is smaller than that of opium, and it is devoid of 
smell. 

The action of the heart becomes slower, and the arterial 
tension is raised. 

The respiration may become irregular from a depressing 
action on the vagi. 

The functions of the spinal cord are stimulated, and hence 
we occasionally meet with restlessness and muscular twitch- 
ings, which in some of the lower animals run on into true 
convulsions. » 

Irritability of the bladder is often observed, and trouble- 
some itching of the skin, depending, in some cases, on the 



334 opium. 

development of a minute papular or vesicular eruption. Some 
years ago a favorite mode of using morphia was by what is 
known as the endermic method, in which the powder w T as 
sprinkled over the raw surface of a blister ; but this has now 
been almost entirely superseded by the hypodermic syringe. 
This ingenious little instrument enables us to inject a small 
quantity of morphia in solution beneath the skin, and the 
relief to suffering is usually immediate, and sometimes per- 
manent. It matters little whether we introduce the remedy 
into the immediate neighborhood of the painful spot, our only 
caution being to avoid the vicinity of large bloodvessels or 
nerves, and to plunge the nozzle or needle of the syringe 
fairly through the skin into the adjacent cellular substance, 
preferably by perpendicular puncture. Some smarting occa- 
sionally follows the entrance of the fluid, which should be 
very slowly pumped in, and inflammation and abscess may 
occasionally be produced; but these accidents are rare, and 
the sting of the primary puncture may readily be obviated 
by freezing the skin with ether-spray. Thes;*, injections are 
now very largely practised for the relief of pain, and more 
especially m facial neuralgia, sciatica, lumbago, in the pas- 
sage of biliary or renal calculi, in cancer, and in a vast 
range of diseases w r here acute suffering is the main symptom, 
we are enabled to give our patients temporary, and sometimes 
permanent, relief. So great, indeed, is the popularity of this 
mode of treatment, that a new school of opium-eating, so to 
speak, has been formed, and morphia-injections have unfor- 
tunately been practised to a great extent as a mere develop- 
ment of self-indulgence. We must, of course, be very careful 
not to give even the most casual or indirect encouragement 
to such disastrous habits. 

Some caution is always requisite in prescribing these injec- 
tions for the first time, as not only severe sickness and vomit- 
ing have followed their use in many cases, but great prostra- 
tion, with failure of the heart's action, and even death. We 
must therefore carefully watch our patient for some time after 
the completion of the little operation. We must never begin 
with a larger quantity than the sixth of a grain ; and we are 
told, on good authority, that the combination of T ^ of atropia 
to each dose of morphia will effectually obviate all risk of 
these unpleasant consequences. For injection we may use 
either the injectio morphias hypodermica [Br.] (containing 
1 gr. of the acetate in every 12 minims), or the elegant and 



COMMON MARJORAM. 335 

convenient gelatine disks prepared .by Messrs. Savory and 
Moore at the suggestion of Dr. Sansom, remembering that 
morphia acts in this way three times more powerfully than 
when taken by the mouth. For internal use we may pre- 
scribe either salt, remembering, however, the varying sus- 
ceptibilities of different persons, and the fact that so small a 
quantity as half a grain has caused death ; or we shall find 
the liquor morphiae hydrochloratis [Br.] or acetatis [Br.], 
containing half a grain to the drachm, a convenient prepa- 
ration. 

Most of the other alkaloids contained in opium are merely 
subjects for physiological curiosity. 

1. Codeta, however, is now frequently used, not for its 
narcotic properties, which are feeble and transient, but for 
an undoubted soothing influence which it exerts over various 
painful affections of the kidney. It is also an established 
remedy in cases of diabetes, checking the secretion of sugar, 
and arresting, in some measure, the progress of the disease. 
Dose, 1 to 3 grs. (.06 to .20 Gm.). 

2. Narceia possesses only one-eighth of the narcotic pro- 
perties of morphia, and is never used in medicine. 

3. Cryptopia is one-fourth as powerful as morphia, and 
in addition to its hypnotic properties it causes in the lower 
animals peculiar illusions of vision, with a tendency to con- 
vulsive action. It also is never used. 

4. Paramorphia or Thebaia is purely excitant, and in 
doses of 1 grain it causes tetanic spasms. 

5. Narcotina has no narcotic properties, but has some 
power as an anti periodic. 

6. Papaverine is narcotic. 

7. Meconine is feebly narcotic. 

8. Apomorphia is a powerful emetic, generally used by 
subcutaneous injection, in doses of -^ gr. (.004 Gm.). 



[ORIGANUM—COMMON MARJORAM. 

The herb of Origanum vulgare, U. S. *• 

Officinal Preparations. 

Oleum Origani. Dose, gtt, ij-v (.12 to .30 Gm.). 

The oil of origanum is rarely used, being largely super- 
seded in commerce by the oil of thyme. It is an aromatic 



336 BONE — PAREIRA BRAVA. 

stimulant. Origanum in infusion has been used as a dia- 
phoretic and emmenagogue, and externally as a fomenta- 
tion.] 



[OS— BONE. 

Introduced as the source of Calcii Phosphas Praecipitata 
and Sodii Phosphas.] 



OVUM—EGG. 

[ The egg of Phasanius Gallus, U. S. 

Used in pharmacy in making emulsions, and is an ingre- 
dient in Mistura Chloroformi.] 

White of egg is of use as an antidote to various corrosive 
poisons, as perchloride of mercury ; and the yelk (vitellus) 
has nutritive properties. 



[PAP AVER— POPPY CAPSULES. 

The nearly ripe capsules of Papaver somniferum, U. S. 

Occasionally, though rarely, employed in decoction or 
cataplasm ; and the Syrupus Papaveris (Br.) is sometimes 
given to children, but is an uncertain preparation.] 



PAREIRA— PAREIRA BRAVA. 

[ The root of Cissampelos Pareira, U. S. 
Officinal Preparations. 

Extractum Pareirse Fluidum. Dose, f3ss-j (2. 
to 4. Gm.). 

Infusum Pareirae. Dose, f^j-ij (32. to 64. Gm.).] 

Local Action. 
Pareira Jias no local action. 

Constitutional Actions. 

Physiological. Therapeutical. 

Digestive and Secreting Pareira is used in various 
Organs Pareira acts in chronic bladder-affections, 



PUMPKIN SEEDS — PHOSPHORUS. 337 

some measure as a diuretic, but it seems to be very un- 
but its main influence is di- certain in its action, 
rected to the bladder, which 
it appears to stimulate and 
strengthen, improving the 
tone of its mucous lining, 
and lessening abnormal se- 
cretions. v 



[PEPO— PUMPKIN SEEDS. 

The seeds of Cucurbita Pepo, U. S. 

Pumpkin-seeds are an efficient tsenicide in doses of one or 
two ounces. The decorticated seeds, beaten into a paste 
with sugar or milk, are given in the morning fasting, fol- 
lowed, in an hour or two, by a dose of castor oil.] 



PHOSPHORUS— PHOSPHORUS. 

[Dose, in substance, gr. 5 L to ^ (.001 to .005 Gm.).] 

Antidotes. 

There is no direct antidote, but turpentine is said to act 
as a prophylactic. [Old oil of turpentine is considered an 
antidote to phosphorus, followed by demulcents and evacu- 
ants.] Sulphate of copper has also been proposed. 

(Phosphorus is not used externally.) 

Physiological Action. Therapeutical Action. 

1. Its action on the ner- 1. Phosphorus is therefore 
vous system is tonic and stim- a valuable agent in nervous 
ulant, repairing the waste of debility, where the brain is 
tissue. weakened by anxiety, worry, 

overwork, or sexual excesses, 
and where too great amount 
of phosphates is excreted by 
the urine ; and still more 
markedly in neuralgia, which 
has been shown by Anstie to 
depend on a feeble state of 
nerve tissue. 

Hammond has advised its 
29 



338 



PHOSPHORUS. 



2. On the circulation it 
acts in the first place as a 
stimulant ; the pulse rises and 
gains in fulness but not firm- 
ness, the face flushes, and 
eventually signs of peripheric 
capillary expansion ensue, 
ending in free perspiration. 
In large doses, however, it 
depresses to a dangerous de- 
gree the heart's action. In 
the anaemia of lymphadenoma 
the number of red blood-cor- 
puscles is increased. 

3. The temperature during 
the administration of phos- 
phorus at first rises slightly, 
next becomes secondarily 
lowered by three or four de- 
grees in consequence of the 
dilatation of the superficial 
capillaries and resulting eva- 
poration from the skin. 

4. On the urine phosphorus 
exerts the following in- 
fluence : Its quantity is in- 
creased, it becomes reddish, 
clouded with lithates, acquir- 
ing a violet smell, and, ac- 
cording to B. von Bauer, its 
proportion of urea is mark- 
edly increased. 

Hematuria results from a 
poisonous dose. 

5. On the intestinal secre- 
tion no effect is produced by 
small doses ; but, in the event 
of a large quantity being 
taken, great and persistent 
irritation of the stomach and 



use in the early stages of 
brain softening from over- 
exertion. 

2. Phosphorus may be 
given with decided benefit 
as a stimulant in typhoid con- 
ditions, where great feeble- 
ness exists, and as a general 
tonic it is of marked value, 
the appetite being sharpened, 
and a general sensation of 
well-being felt. 



5. Much discussion has 
recently arisen respecting the 
remedial powers of phospho- 
rus in leucocythcemia and 
pernicious ancemia, but the 
evidence is too conflicting 



PHOSPHORUS. 



339 



intestines results, causing 
pain, vomiting, and purging. 
Jaundice is also a symptom 
of its poisonous action, and 
after death fatty degeneration 
of the liver is generally found. 
As biliary acids are found in 
the urine, it is believed that 
the jaundice is due to ob- 
struction of the ducts. 

6. To the skin, phosphorus 
acts in some measure as an 
irritant. Purpura occasion- 
ally appears as a symptom of 
its poisonous action. 



7. Its effects on the osseous 
tissue are remarkable, as it 
has the property of causing 
necrosis of the jaw-bone, and 
this used to be common in 
lucifer-match makers. Some 
interesting experiments by 
Wegner have recently shown 
a marked influence of phos- 
phorus in promoting the 
formation of bone ; for when 



(although opposing on the 
whole) to enable us to come 
to any decided opinion at 
present. The remedy is well 
worth trying, however, in 
these otherwise desperate 
cases, and Broadbent has 
recorded one remarkable suc- 
cess. 

6. On this account, be- 
cause of its stimulating the 
cutaneous circulation, phos- 
phorus has been given with 
success in the eruptive fevers, 
such as scarlet fever, measles, 
etc., to develop an insuffi- 
ciently developed, or prema- 
turely faded, eruption, on 
account of its chemical and 
physiological affinities to 
arsenic it has been found of 
service in the treatment of 
chronic eczema and psoriasis. 
Broadbent explains its action 
by its effecting a change in 
the blood through a general 
influence on cell-growth in 
all the tissues and organs, 
and of especial influence on 
cell-growth in the skin as the 
drug passes through it. 

7. The experiments of 
Wegner w r ould indicate its 
use in rickets. 



340 PHOSPHORUS. 

given to growing animals the 
cancellous tissue was rapidly 
transformed into hard bone, 
and, even in the case of those 
fully developed, the medul- 
lary canal was sensibly dimin- 
ished by its use. Also, in 
cases of artificial fracture, not 
only was the resulting repair 
more rapid, but the quantity 
of bone thrown out was far in 
excess of the usual amount. 

Poisonous Effects. 

These we have seen to consist of intestinal irritation, car- 
diac syncope, and death from exhaustion, the post-mortem 
disclosing fatty and parenchymatous degeneration of liver, 
muscles, and tissues generally. 1-| gr. has proved fatal. 
The blood becomes black, unduly liquid, and loaded with the 
products of tissue decomposition, such as uric acid, creatine, 
leucine, tyrosine, etc., this resulting from the ozonizing pro- 
perties of the poison. 

Phosphorus is given out from the system principally by 
the urine, the drug being oxidized in the system and elimi- 
nated as phosphates. 

CONTRA-INDICATIONS AND DISADVANTAGES. 

We must generally feel our way in prescribing phosphorus, 
and begin with small doses, for some persons are more sus- 
ceptible than others to its over-action, and Anstie records a 
case in which three or four ^ gr. doses gave rise to long- 
continued epigastric pain. Nor must we forget its tendency 
to cause fatty degeneration of internal organs, which is due 
to the formation of fat in situ from their albuminous con- 
stituents, by increased tissue change, and diminished oxi- 
dation. 

Mode of Administration and Dose. 

Much of our success, however, in giving phosphorus de- 
pends on the mode in which it is prescribed, and, as a general 
rule, capsules containing ^ grain are found to be a conve- 



CALABAR BEAN. 341 

nient medium. It also goes well with cod-liver oil, but it is 
very difficult indeed to devise any liquid formula by which 
it is prevented from becoming rapidly inert by oxidation. 
Most of the pill-masses are useless from being made with in- 
soluble materials which pass through the bowels unchanged. 
The dose, speaking generally, is from ^L- to -^ grain ; or 
we may give the phosphide of zinc, a very convenient and 
reliable preparation, much praised by Ashburton Thompson, 
[in pills containing] from y 1 ^ to ^ grain. 



PHYSOSTIGMA— CALABAR BEAN. 

[The seed of Physostigma venenosum (Balfour), U. S.~\ 
The ordeal bean of Old Calabar. 

[Officinal Preparation. 

Extractum Physostigmatis. Dose, gr. i to ^ (.01 
to .02 Gm.).] 

Antidotes. 

In addition to the general principles of treating this form 
of poisonous action, we have here two physiological reme- 
dies at command — (1) atropia, which directly antagonizes 
the respiratory depression ; and possibly (2) strychnia, 
which stimulates the cord. 

Local Actions. 

Physiological. Therapeutical. 

When applied to the sur- Calabar bean is therefore 

face of the body, Calabar of use in ophthalmic surgery, 

bean exerts no special influ- to counteract the dilating 

ence, but when introduced effect of belladonna, and to 

to the eye it causes very prevent prolapse of the iris 

complete contraction of the in cases of corneal injury or 

pupil. ulceration. 

Constitutional Actions. 

I. On Nervous System 

1. The brain is quite un- 
affected, the mind, in cases of 

29* 



342 



CALABAR BEAN 



poisoning, remaining clear 
almost to the last. 

2. The spinal cord, how- 
ever, is specially attacked, 
and to a diminution of its 
motor power is due the mus- 
cular enfeeblement and final 
paralysis which affect those 
brought fullv under the in- 
fluence of this drug. A still 
more remarkable result, how- 
ever, is the total abolition of 
all reflex activity, the most 
energetic stimulation failing 
to elicit the slightest response. 



3. Although, in the first 
stage of Calabar bean action, 
the motor nerves are unaf- 
fected, a secondary lessening 
of their conductivity is 
noted, and, with reference 
to the sympathetic system, 
an early excitation is fol- 
lowed by a secondary de- 
pression. 



2. The depressing action 
of Calabar bean on the re- 
flex powers of the spinal 
cord led Fraser to propose 
it as a remedy for tetanus , 
and this mode of treatment 
has proved very satisfactory 
in alleviating the symptoms 
and checking the course of 
this terrible disease. It is 
of great importance that the 
drug should be early used 
and vigorously pushed, as 
there is every reason to be- 
lieve that the cord is free 
from marked pathological 
changes during the first pe- 
riod of the disease. 

Calabar bean has been 
tried without success in cho- 
rea, epilepsy, and other ner- 
vous disorders ; but recently 
Dr. Crichton Browne has 
expressed his conviction, 
founded on the observation of 
a few cases, that it may prove 
useful in the general paraly- 
sis of the insane. 

It has also been found to 
act as an effective antidote in 
strychnia-poisoning. 



CALABAR BEAN. 343 



The contraction of the iris 
noted above, which takes 
place equally on local or in- 
ternal administration, is con- 
sidered due to paralysis of 
the peripheral vaso - motor 
nerve fibres, and to stimula- 
tion of the terminal filaments 
of the third nerve. 

II. Circulating Appa- 
ratus. — Under small doses of 
Calabar bean, the heart's 
action becomes slower and 
stronger, and the arterial 
tension is notably increased ; 
but when the system is 
brought more fully under 
the poisonous influence of 
the drug, the cardiac pulsa- 
tions become feeble and 
irregular, and finally cease. 
These results are believed 
to be due to stimulation and 
subsequent exhaustion of the 
peripheral cardiac filaments 
of the vagi, and the primary 
contraction and subsequent 
relaxation of the arteries are 
explained in the same way. 

III. Respiration and Tem- 
perature. — The breathing 
usually becomes slow and 
irregular, and the tempera- 
ture falls a little. 

IV. Secreting Organs — - 
Calabar bean tends to cause 
vomiting, with violent and 
painful contraction of the 
stomach and increased peri- 
staltic movement of the in- 
testines. 

Increase in the salivary 
and cutaneous secretion has 
also been observed. 



344 pills — pimento. 

Poisonous Action. Cautions. Mode of 
Administration. 

Calabar bean in small doses destroys life by paralyzing 
the respiratory centre and causing suffocation, but in larger 
quantity it proves more speedily fatal by cardiac syncope. 

Caution is of course necessary in dealing with so poison- 
ous a substance as this. It is seldom used internally, for in 
tetanus the functions of the stomach are suspended in great 
measure, and drugs are probably only very partially absorbed. 
Subcutaneous injection is therefore our best method, and 
we use a solution of the extract (from ^ to ^ gr. or .01 to .02 
Gm.), neutralizing its irritating acidity by the addition of a 
little soda. 

The alkaloid eserina, said to be the active principle, is 
unstable and difficult to extract, and is therefore practically 
useless. [The sulphate of eserina is ten times the strength 
of the extract.] 

[Pilulae. 

The officinal Pills are — 

Pilulae Aloes • Pilulae Ferri Iodidi 

" " et Assafoetidae " Gralbani Compositae 

" " et Masticlies " Hydrargyri 

" " etMyrrhae " Opii 

" Antimonii Compositae " Quiniae Sulphatis 

" Assafoetidae " Rliei 

" Catharticae Compositae " " Compositae 

" Copaibae " Scillae Compositae 

' ' Ferri Compositae 

Two Pill-masses are officinal : Pilula Ferri Carbonatis 
and Pilula Saponis Composita.] 



[PIMENTA— PIMENTO. 

Syn. Allspice. 
The unripe berries of Eugenia Pimento, (De Candolle), U. S. 

Officinal Preparation. 

Oleum Pimentae. Dose, gtt. iij-vj (.20 to .40 Gm.). 

Pimento is a warm, aromatic stimulant, but is more used 
as a condiment than as a medicine. As a carminative, the 
dose is from ten to forty grains 1^.65 to 2.65 Gm.).] 



BLACK PEPPER CANADA PITCH. 345 

PIPER— BLACK PEPPER. 

[ The unripe berries of Piper nigrum, U. S. 

Officinal Preparation. 

Oleo-resina Piperis. Dose, ny (.06 Gm.).] 

Pepper is an acrid stimulant, acting more especially on 
mucous membranes, and hence, as a condiment, it is sup- 
posed to excite the secretion of the gastric juice. In former 
years it also acquired some reputation as a remedy for hemor- 
rhoids. [Piperin, not officinal, is sometimes added to anti- 
periodic pills, but it is certainly active, although it has been 
stated that it owes its effects to an impurity, the active oil 
of pepper.] 



PIX BURGUNDICA— BURGUNDY PITCH. 

[ A prepared resinous exudation from Abies excelsa (Lamarck's 
Enci/. Method.), U. S. 

Enters into Emplastrum Antimonii, Emp. Ferri, Emp. 
Galbani Compositum, Emp. Opii, Emp. Picis Burgundicae, 
and Emp. Picis cum Cantharide.] 

Pitch is used externally in the form of plaster. 



[PIX CANADENSIS— CANADA PITCH. 

Sjjn. Hemlock. 

The prepared resinous exudation from Abies Canadensis (Michaitx, 
N. Am. Silva), U. S. 

Officinal Preparation. 

Emplastrum Pieis Canadensis. 

Used only in the form of the plaster. The oil of the 
Abies, or Pinus, Canadensis, or Hemlock Spruce (oil of 
spruce, oil of hemlock), has been given to produce abortion. 
A fluid extract of the bark (Ext. Pinus Canadensis fluid.), 
not officinal, is largely used as an astringent for gargles, 
vaginal douches, etc.] 



346 



TAR 



PIX LIQUIDA— TAR. 

[ The impure turpentine from the wood of Pinus palustris, and of other 
species of Pinus, prepared by burning, U. S. 

Officinal Preparations, U. S. 

Glyceritum Picis Liquida& (n^xxx, in f 3 j ) . Dose, 
f3i-iv (4. to 16. Gm.). 

Infusum Pieis Liquidse (Tar 20 per cent.). Dose, 
fgss-j (16. to 32. Gm.). 

Unguentum Pieis Liquidae (Tar, 50 per cent.).] 



External Actions. 



Physiological. 

Tar acts as a stimulant to 
the skin, and is apt to pro- 
duce an irritable papular 
eruption. It is rapidly ab- 
sorbed, and if allowed to 
remain in contact with the 
surface of the body, or if 
applied over an extensive 
cutaneous area, feverish 
symptoms ensue, with an 
abundant discharge of black- 
ish urine, smelling strongly 
of tar. 



Therapeutical. 

Tar is an excellent appli- 
cation in cases of chronic 
scaly skin diseases, as psori- 
asis. 

To lessen the risk of ex- 
citing an undue amount of 
irritation, it is well to wash 
the skin perfectly clean be- 
fore renewing the application, 
and it is important to rub in 
the ointment thoroughly until 
it nearly disappears. 



Internal Actions. 



Tar seems to have a stimu- 
lating action on mucous mem- 
branes when taken internally. 
[Tar contains a certain pro- 
portion of creasote, upon 
which some of its therapeutic 
effects depend.] 



The vapor of tar used to 
be a remedy of some repu- 
tation in chronic bronchitis, 
and recently Prof. Ringer has 
recommended two-grain pills, 
three times a clay, as a most 
efficient remedy in winter- 
cough. The internal use of 
tar has also been praised by 
Dr. McCall Anderson in 
chronic skin diseases. [The 



LEAD. 347 

syrup of tar (3j in f^iv) 
is not officinal, but may be 
given in advanced bronchitis, 
in half- ounce doses. The 
infusion is stimulant and diu- 
retic] 



PLUMBUM— LEAD. 

[Officinal Preparations, U. S. 

Plumbi Oxidum (Litharge). Used in making Emplas- 
strum Plumbi (Diachylon or Lead-plaster), which en- 
ters into Emplastrum Assafcetidae, Emplastrum Ferri, 
Emplastrum Galbani Compositum, Emplastrum Hy- 
drargyri, Emplastrum Opii, Emplastrum Resinae (Ad- 
hesive plaster), Emplastrum Aconiti, Emplastrum Ar- 
nicas, Emplastrum Belladonnas, Emplastrum Saponis, 
Ceratum Saponis. 

Liquor Plumbi Subaeetatis (Goulard's extract). 
Liq. Plumbi Subaeetatis Dilutus (lead-water). 
Ceratum Plumbi Subaeetatis (Goulard's cerate). 
Linimentum Plumbi Subaeetatis. 

Plumbi Aeetatis (Sugar of lead). Dose, gr. ij-v (.12 
to .30 Gm.). 
Suppositoria Plumbi (each gr. iij). 

Suppositoria Plumbi et Opii (each gr. iij, and Ext. Opii 
gr. ss). 

Plumbi Carbonas. 

Unguentum Plumbi Carbonatis (3j in Jj). 

Plumbi Nitras (used as a disinfectant — Ledoyen's solu- 
. tion). 

Plumbi Iodidum. 

Unguentum Plumbi Iodidi.] 

Poisonous Effects. 

The first sign of chronic lead-poisoning is a bluish line 
running along the free margin of the gums composed of mi- 
nute dots, and depending on the actual deposition of lead in 
the mucous membrane. To this succeed colic, wrist-drop, 






348 LEAD. 

and the other symptoms mentioned above, the post-mortem 
disclosing chronic catarrh of the stomach and intestines, 
with the deposition of the metal in the bones, liver, kidney, 
brain, nervous and muscular fibres. 

Chronic lead-poisoning has occasionally resulted from adul- 
terated cider or from water, and indeed in a variety of ways, 
but it is most common in painters, who are brought much in 
contact with the carbonate in the practice of their business. 

Antidotes and Treatment. 

[Sulphuric acid forms an insoluble compound with lead, 
and, therefore, the soluble sulphates (alum, Epsom salts) are 
chemical antidotes to lead-poisoning ; they often are given 
combined with sulphate of morphia to relieve pain and relax 
spasm.] Salt is said to be useful, because the metal is natu- 
rally eliminated from the kidneys as a chloride. 

In poisoning by lead, we must give sulphate of magnesia, 
iodide of potassium, sulphur baths, and remove its after- 
effects by galvanism of the paralyzed muscles ; but it is stated 
that sulphuric-acid lemonade, and a liberal indulgence in 
fatty articles of diet, may act in some degree as prophy- 
lactics. 

Local Actions. 

Physiological. Therapeutical. 

The external action of lead Lead, in the form of sub- 
is partly sedative and partly acetate, is much used as lotion 
astringent. [All the prepara- for erysipelas, acute eczema, 
tions of lead are used exter- and various ulcerative condi- 
nally, but the acetate appears tions. 

to be the only one adapted It forms a good collyrium 
for internal use.] in the more superficial inflam- 

Squire praises a glycerate mations of the eye ; but -we 
of the subacetate of lead very must remember that its ten- 
highly in eczema. dency to deposition may cause 

a permanent white patch in 
corneal ulcers. 

The powder of nitrate of 
lead has been shown to be a 
good application in onychia 
maligna. 



LEAD. 



349 



Internal Action and Uses. 



1. Brain and Nervous 
System. — When lead is given 
in poisonous doses, a curious 
train of nervous symptoms 
show themselves, beginning 
with violent neuralgic pains 
and giddiness, and running 
on into delirium, with epilep- 
tiform convulsions, and subse- 
quent melancholia. Sclero- 
sis of the areolar tissue, with 
diminution of the nervous ele- 
ments, has been found in cer- 
tain of the sympathetic gan- 
glia, but more especially the 
coeliac and cervical ganglia. 
Atrophy of the optic nerve is 
an occasional, though rare, 
complication of lead-poison- 
ing. 

2. Heart and Circulation. 
— During the action of lead, 
the heart becomes slow and 
the pulse smaller and harder, 
indicating a condition of con- 
traction and tension of the 
arterial system ; and this is 
by some supposed to be due 
to a primary effect on the 
sympathetic, w r hilst others 
hold that lead has a direct 
influence over unstriped mus- 
cular fibre, and most power- 
fully over that which encir- 
cles the arteries. Lead tends 
to produce pallor by destroy- 
ing the red blood-corpuscles. 

3. Intestinal Tract A 

prominent symptom of chro- 
nic lead-poisoning is obsti- 

30 



2. This contractile influ- 
ence of lead over the smaller 
vessels explains its action in 
internal hemorrhage, as we 
know that haemoptysis, more 
especially, may be very suc- 
cessfully treated by acetate of 
lead in doses of from -|- gr. to 
3 grs. (.03 to .20 Gm.). 



3. Acetate of lead is an 
excellent astringent in diar- 
rhoea, more especially that of 



350 



LEAD. 



nate constipation, depending 
probably on contraction of 
the small intestine, and asso- 
ciated with violent colicky 
pain around the umbilicus. 
The appetite at the same 
time becomes bad, the tongue 
loaded, and nausea and even 
vomiting are observed. Gas- 
tro-enteritis is generally one 
of the symptoms of acute 
poisoning. 

4. Urinary System — Lead 
has the curious property of 
obstructing the elimination 
of uric acid from the blood 
through the kidneys, and may 
thus cause gout in painters 
and others who are exposed 
to the effects of the metal. 

5. Muscular Lead causes 

violent pains in the muscles, 
with a peculiar form of para- 
lysis affecting the extensors 
of the fore-arms, and causing 
the well-known wrist-drop ; 
and post-mortem we find fatty 
degeneration of the muscular 
structures. 

The contracting power of 
lead over unstriped muscular 
fibre probably explains the 
tendency to abortion noled 
during its poisonous influ- 
ence. 



phthisis, and British [or spo- 
radic] cholera. 

Dr. Thorowgood has ob- 
tained good results from lead 
in obstinate obstruction oj the 
bowels. 



Mode of Elimination. 

Lead is thrown out of the system by the urine, skin, 
bowels, and lacteal glands. 



MAY APPLE. 351 



Mode of Administration, etc. 

If we wish to administer lead internally, we generally 
prescribe either the acetate or pil. plumbi com opii [Br.] 
(1 gr. of opium in 8), dose, 4 to 8 grs. (.25 to .50 Gm.). 

Externally we find the liquor plumbi subacetatis dilutus 
the most convenient form. 



PODOPHYLLUM— MAY-APPLE. 

[ The rhizome of Podophyllum peltatum, U. S. 

Officinal Preparations, U. S. 

Extraetum Podophylli. Dose, gr. v-xv (.30 to 1. 
Gm.). 

Resina Podophylli (sometimes called podophyllin). 
Dose, gr. |-J (.007 to .015 Gm.).] 

Local Action. 

Podophylli n cannot penetrate the unbroken cuticle, but 
experiment has shown that it exerts its purgative influence 
when applied to a raw surface. 

Constitutional Actions. 

Physiological. Therapeutical. 

The only marked physio- Podophyllin is a valuable 

logical property of this drug remedy in jaundice and in 

is that of irritating the duo- the various forms of func- 

denum and causing a profuse tional liver affection. It 

flow of watery evacuations, may be used in simple chronic 

largely mixed with bile, constipation, in the constipa- 

Some controversy has taken tion of children attended with 

place as to whether podo- the painful and difficult eva- 

phyllin can be called a chola- cuation of hard, dry feces, 

gogue in virtue of any direct and in the opposite condition 

stimulation of the secreting of diarrh&a with pale and 

structures of the liver, ex- frothy motions, 

perimental evidence seeming In sick headache it also 

to show that it probably acted acts well. 

by contracting the gall- [Podophyllum is an effi- 

bladder, and thus favoring cient substitute for jalap, and 



352 POTASSIUM. 

the expulsion of its contents, may be used for all purposes 
and by exciting the duodenum for which the latter drug has 
to sweep away the bile ef- been recommended.] 
fused into it by the hepatic 
ducts. The more recent ex- 
periments of Rutherford and 
Vignal, however, have re- 
instated podophyllin in its 
old position as a true stimu- 
lant of the biliary secretion. 

Cautions and Mode of Administration. 

We must remember that podophyllin is an uncertain drug, 
acting well in some cases, very slightly in others, whilst in a 
third class it causes much discomfort and griping. It is ad- 
visable, therefore, always to begin with small doses, as \ gr. 
or \ gr., and to prescribe it in the form of pill, combined 
with other ingredients which may restrain its irritating 
action. Thus : — 

R. Resinse podophylli gr. ij ; or )12 Gm. 

Extracti belladonna? gr. iij ; " 20 " 

Pil. colocyntliidis composite gr. xxxvj; " 2| 30 " M. 

Fiant pilulse duodecim, quaruni capiat unam omni nocte. 

Ringer recommends a very convenient way of prescribing 
podophyllin for children, by dissolving a grain in a drachm 
of rectified spirit, and giving 5 or 6 drops three or four times 
a day, on a lump of sugar [or it may be simply painted on a 
bun]. 



POTASSIUM— POTASSIUM. 

[Officinal Preparations, U. S. 

Potassa. Caustic Potassa. 

Liquor Potassae. Dose, n^x-xxx (.65 to 2. Gm.). 
Potassa cum Calce (equal parts), used as a caustic. 

Potassii Aeetas. Dose, gr. xx-5j (1.30 to 4. Gm.). 

Potassii Bichromas (as an alterative). Dose, gr. J 
(.01 Gm.). 
(Used in preparing Sodii Yalerianas.) 

Potassii Bitartras (Cream of Tartar). Dose, 3j-iv (4. 
to 16. Gm.). 



POTASSIUM. 353 

Antimonii et Potassii Tartras, Ferri et Potassii Tartras, 
Potassii et Sodii Tartras (Rochelle Salt), Potassii Tar- 
tras, Pulvis Jalapse Compositus. 

Potassii Bromidum. Dose, gr. xx-5j (1.30 to 4. Gm.). 

Potassii Carbonas Impura (Pearlash). 

Potassii Carbonas. Dose, gr. x— xxx (.65 to 2. Gm.). 

(Extractum Spigelian et Senna? Fluidum, Mistura Ferri 
Composita, Potassii Bicarbonas, Potassii Sulphuretum, 
and in making Chloroformum Purificatum and Spiritus 
JEtheris Nitrosi.) 

Potassii Carbonas Pura. Dose, gr. x-xxx (.65 to 2. Gm.). 
(Used in making Potassium Bromide and Cyanide, and 
Mistura Potassii Citratis.) 

Potassii Bicarbonas. Dose, gr. x-5j (.65 to 4. Gm.). 

(Liquor Magnesia Citratis, Liquor Potassae, Liquor Po- 
tassii Arsenitis, Liquor Potassii Citratis, Mistura Po- 
tassii Citratis, Potassii Acetas, Potassii Carbonas Pura, 
Potassii Citras.) 

Potassii Chloras. Dose, gr. v-xx (.30 to 1.30 Gm.). 
Trochisci Potassii Chloratis. 

Potassii Citras. Dose, gr. x-xxx (.65 to 2. Gm.). 
Liquor Potassii Citratis. Dose, f Hjss (16. Gm.). 

Potassii Cyanidum. Dose, gr. T L to T \ (.005 Gm.). 

Potassii Ferroeyanidum. Dose, gr. x-xv (.65 to 1. 

Gm.). 
(Used in making Acidum Hydrocyanicum Dilutum, Ar- 

genti Cyanidum, Ferri Ferroeyanidum, Hydrargyri 

Cyanidum, and Potassii Cyanidum.) 

Potassii Hypophosphis. Dose, gr. x-xxx (.65 to 2. 
Gm.). 

Potassii Iodidum. Dose, gr. x-3j (.65 to 4. Gm.). 
(Ammonii Iodidum, Hydrargyri Iodidum Rubrum, Liquor 
Iodinii Compositus, Plumbi Iodidum, Tinctura Iodinii 
Composita, Unguentum Iodinii, Unguentum Iodinii 
Compositum, Unguentum Potassii Iodidi (3J to ^j).) 

Potassii Nitras. Dose, gr. x-xv (.65 to 1. Gm.). 

Potassii Permanganas. Dose, gr. j-v (.06 to .30 Gm.). 
Liquor Potassii Permanganatis (gr. iv to f '^j). 

Potassii Sulphas. Dose, gr. xx-5 iv (1.30 to 16. Gm.). 
Pulvis Ipecacuanhae Compositus. (Dover's powder.) 

Potassii Sulphis. Dose, gr. xv-5j (1. to 4. Gm.). 

30* 



354 POTASSIUM. 

Potassii Sulphuretum. Dose, gr. ij-v (.12 to .30 Gm.). 

Potassii et Sodii Tartras (Rochelle Salt). Dose, ^ss-j 
(1G. to 32. Gm.). 

Potassii Tartras. Dose, 3j-gj (4. to 32. Gm.). 

Poisoning. 

Caustic potassa is a corrosive mineral poison. The 
symptoms produced by it are an acrid, caustic, urinous taste 
in the mouth, a sensation of burning heat in the throat, 
nausea, and sometimes vomiting of bloody matters. The 
surface becomes cold and clammy ; the pulse quick and feeble ; 
and there is often hypercatharsis, and violent colicky pains. 

Morbid Appearances — Strong marks of inflammation in 
the alimentary canal, with softening, erosion of the mucous 
coat, and, in some cases, perforation of the stomach. 

Tests. 

The alkaline reaction. It precipitates silver nitrate in the 
form of a dark-colored oxide. Carbonic acid water causes 
no precipitate. A concentrated solution, acidulated with 
muriatic acid, affords a deep-yellow precipitate with platinum 
bichloride. A solution of tartaric acid causes a white preci- 
pitate of cream of tartar. 

Antidotes. 

Vinegar and the diluted vegetable acids ; to be followed 
by a free use of demulcents, or oleaginous mixtures.] 

Local Actions. 

Physiological. Therapeutical. 

Caustic potash is a most Caustic potash, either in 
powerful escharotic, with- sticks or combined with lime 
drawing water from the tis- in the form of potassa cum 
sues, and thus destroying calce, was formerly used in 
them. It has, however, the the treatment of various 
disadvantage of being very forms of ulceration, and for 
deliquescent, and this ten- the production of issues, 
dency to spread, beyond the which barbarous relics of 
part we wish to attack, has antiquity are now fortunate- 
led to its practical abandon- ly discarded from practice, 
ment as a local application. Liquor potassae has been re- 



POTASSIUM. 355 

commended to soften the 
great toe-nail and facilitate 
its removal when ingrowing ; 
and the bicarbonate of pot- 
ash forms a good lotion in 
acute eczema, as an injection 
in leucorrhoea, and as an ap- 
plication to rheumatic joints. 
The permanganate of pot- It is therefore antiseptic, 
ash (Condy's fluid) oxidizes and a good application to un- 
and destroys many organic healthy ulcerations, 
substances. 

Internal Actions and Uses. 
Physiological. Therapeu tical. 

1 . Brain and Nervous Sys- 
tem -Potash salts, and more 

especially the nitrate, when 
given in large doses, exert a 
paralyzing action on the spi- 
nal cord, producing great 
muscular weakness and finally 
abolition of reflex sensibility. 

2. Heart and Circulation. 
— Moderate doses of the ni- 
trate raise the arterial tension 
and slow the heart's action, 
and if the drug is further 
pushed, the pulsations be- 
come weaker, still slower, 
and finally irregular, before 
the total arrest of movement 
supervenes. It prevents the 
coagulation of the fibrine, and 
the red corpuscles are re- 
strained in their functions of 
oxygenation. Gubler de- 
scribes a sort of chronic poi- 
soning in those who eat ham 
treated by pot. nit. to heighten 
its color, and consisting of 



356 



POTASSIUM. 



weakness, palpitation, anae- 
mia, and a kind of scurvy. 

Potash salts cause the 
blood, and secondarily, the 
urine, to become alkaline, 
and any excess of uric acid 
may thus become neutralized. 



3. Intestinal Tract. — Chlo- 
rate of potash moderates ex- 
cessive action of the salivary 
glands, and assists the heal- 
ing of ulceration about the 
gums, mouth, and throat. 
The salts of potash generally 
neutralize free acid in the 
stomach and intestines, and 
the nitrate in full doses may 
cause death by gastro-ente- 
ritis. Most of the potash 
salts are slightly purgative, 
but only the acid tartrate has 
any very decided action of 
this kind, causing as it does 
the abstraction of a large 
quantity of watery fluid, with- 
out, however, stimulating the 
peristaltic movement of the 
intestines. The sulphate is 
also aperient in its action. 



2. This has been supposed 
to explain the beneficial ac- 
tion of potash in acute rheu- 
matism, which is held to de- 
pend on an excess of uric 
acid. Much controversy has 
taken place with reference to 
the alkaline treatment of this 
disease, but I am decidedly 
of opinion that if large doses 
of bicarbonate of potash do 
not shorten its duration, they 
relieve symptoms, and lessen 
the tendency to cardiac com- 
plications. Potash acts well 
also in gout and chronic rheu- 
matism by forming a soluble 
salt with uric acid. 

3. Chlorate of potash, in 
doses of from 5 to 20 grains, 
is an admirable remedy in 
mercurial salivation, in va- 
rious aphthous conditions, 
and in sore throat, whether 
produced by [diphtheritic 
croup'], scarlet fever, or ordi- 
nary tonsillar inflammation, 
and a wash or gargle may 
well be combined with its 
internal administration. 

In doses of from 120 to 
300 grains, cream of tartar 
is a good purgative, but is 
principally used in combina- 
tion with jalap, which, by 
stimulating the muscular 
movements of the small in- 
testines, prevents the proba- 
ble reabsorption of the watery 
fluid. 



POTASSIUM. 



35T 



4. On Secreting Organs — 
It will be remembered that, 
in speaking of acids, we re- 
ferred to a law which has 
been more especially devel- 
oped by Ringer, and which 
explains their power of check- 
ing acid secretions. Alkalies 
have precisely the opposite 
effect, arresting the activity 
of glands furnishing; alkaline 
fluids, whilst they directly 
stimulate those whose secre- 
tion partakes of the opposite 
character. 



Kidneys. — Most of the 
salts of potash, but more es- 
pecially the acetate, nitrate, 
citrate, and acid tartrate, are 
diuretic, and the acetate, bi- 
carbonate, and citrate, being 
converted into carbonate, 
speedily render the urine al- 
kaline. Elaborate experi- 
ments have been made on the 
more precise alterations ef- 
fected in the urine by the 
salts of potash. Prof. Parkes 
tells us that liquor potassae 
increases the destructive 
metamorphosis of the nitro- 
genous tissues, and their 
elimination as urea, as well 
as that of the sulphur in the 
form of sulphates. The ace- 
tate has been shown to di- 
minish the water, urea, and 
earthy salts ; whereas the 
citrate, according to Dr. Nun- 
neley, increases the water, 
but diminishes the urea and 
solids. 



4. We can therefore read- 
ily explain, on physiological 
principles, why alkalies are 
so useful in hepatic conges- 
tion, why they may also stim- 
ulate the pancreatic secre- 
tion, and why their action is 
so beneficial in cases of dys- 
pepsia depending on deficient 
supplies of gastric juice. On 
these principles, also, we may 
readily understand the very 
striking power possessed by 
a weak solution of potash in 
arresting the alkaline secre- 
tion so freely poured out by 
the skin in acute eczema. 

Potash salts are therefore 
good diuretics in heart dis- 
ease, chronic kidney affec- 
tions, and various dropsical 
accumulations ; and their ac- 
tion is much more marked 
under these conditions than 
when administered to healthy 
subjects, since we have seen 
that the acetate, which is 
perhaps the most active of 
the diuretic group, may even 
check the elimination of 
water from the kidneys dur- 
ing health. Dr. Roberts, of 
Manchester, has proposed to 
dissolve uric acid calculi by 
keeping the urine alkaline 
for months with citrate of 
potash. 



358 POTASSIUM. 

Potash may be used under other conditions. Thus in 
asthma the inhalation of the fumes from burnt blotting- 
paper soaked in a strong solution of nitrate of potash is often 
effectual; chlorate of potash is a useful ingredient in a cough 
linctus ; the citrate is an agreeable febrifuge, and is valuable 
in many of the feverish and dyspeptic affections of children. 

Duckworth (Practitioner, May, 1878) highly praises 
nitre paper in bronchitis, and says that a little Friar's bal- 
sam painted over the paper is an improvement. This treat- 
ment in asthma often fails from the fumes not being used 
freely enough. 

Scurvy is held by some to be dependent on a deficiency 
of potash salts in the blood. 

Poisonous Action. 

Partly from depression of the heart and partly from in- 
flammation of stomach and intestines. 

Mode of Elimination. 

The potash salts, having a high diffusive power, pass 
readily into the blood, and are given out by the urine, in 
which the nitrate, chlorate, and sulphate reappear unchanged. 



M. 



]$.. Liquoris potassae 


f m ; 


or 


8 


Gm. 


Tincturae calumbae 


f5ij; 


u 


8 


i'i 


Infusi calumbae 


flvj ; 


a 


192 


a 


Fiat mist, f §j ter in die. 


■ 






Antacid mixture. 








J$. Potassii bicarbonatis 


5j ; 


or 


4 


Gm. 


Potassii acetatis 


gr. xv ; 


n 


1 


a 


Potassii nitratis 


gr. x; 


a 




65 " 


Aquae 


f§U; 


a 


64 


a 



M. 

Fiat haustus quartis horis sumend. 

This constitutes the " full alkaline" treatment recom- 
mended by Dickinson for acute rheumatism, and may be 
prescribed in effervescence. 

[fy. Potassii cliloratis 5M '■> or 

Syrupi limonis f §j ; " 

Aquae f |iij ; " 

Dose, according to the age of the child 
years f 5j, from two to ten f'5u> over ten f sss, given every 
three hours, or every half hour in urgent cases. Recom- 



8 


fim. 




32 


i i 




96 


(< 


M. 


if 


under 


two 



BICHROMATE OF POTASSIUM. 



359 



mended as almost specific in diphtheritic croup by Dr. T. 
M. Drysdale.] 

R. Potassii cliloratis 

Aquae 
S. f §j ter die. 

In ulcerated mouth or gums, or mercurial salivation 



5i; 
f3vj 



or 



4|Gm. 
1921 " 



R. Potassii bicarbonatis t ^ss ; 

Aqua? Oj ; 

A good lotion in acute eczema. 

R. Potassii acetatis giss ; 

Aceti scillse f £iv ; 

Decocti scoparii [Br.] ad f§vj ; 
Fiat mist. Dose, f ^j quartis lioris. 

Diuretic mixture. 

R. Spiritus a3theris nitrosi f 3ij I 

Potassii nitratis gr. xx ; 

Decocti scoparii [Br.] t'^iv ; 

Fiat mist. Dose, 13 j ter die. 

Diuretic. 

R. Potassii bitartratis .^iij ; 

Succi scoparii [Br.] 5 V J ! 

Aquae fgvj ; 
Dose, f §j ter die. 

Diuretic. 

R. Potassii cliloratis gr. xl ; 

Glycerinae f 3 SS > 

Morphias muriat. gr. jss ; 

Syrupi ad f ^iv ; 

S. f 5j prout res poscit. 



or 



or 



2 
500 



Gm. 



6|Gm. 

16 " 
192 " 



or 



1 

128 



Gm. 



30 



or 



12Gm. 
24 " 
192! " 



or 



2 
16 

128 



60 Gm. 
10 " 



M. 



M. 



M. 



M. 



M. 



M. 



Dr. Douglas Power's linctu; 
tion of consumptive patients. 



for the chronic throat irrita- 



[Potassii biehromas. 

Potassic bichromate, in powder or strong solution, is a 
good escharotic and antiseptic application to warts, and ve- 
nereal excrescences. It has been used internally in secondary 
syphilis, as an alterative, given in pill-form, with some 
bitter extract. Occasionally it produces salivation. It acts 
as an emetic in doses of f gr. In large doses it is an acrid 
mineral poison, and causes a burning heat in the mouth, 



360 



BROMIDE OF POTASSIUM. 



throat, and stomach ; excessive and painful vomiting of 
bloody mucus; convulsions and palsy and death. 

Morbid Appearances — Softening and abrasion of the 
mucous coat of the stomach and intestines. 

Tests — In substance, by its orange-red color. In solu- 
tion, by affording a rich red precipitate with nitrate of silver, 
a bright yellow with acetate of lead, a dingy green color and 
whitish turbidity with sulphuretted hydrogen. 

Treatment — The use of the potassic or sodic carbonates 
to neutralize the excess of chromic acid, followed by the ad- 
ministration of emetics. It would also be advisable to employ 
chalk or magnesia, in connection with milk, or the albumen 
of eggs.] 

Potassii Bromidum. 

(Bromide of Potassium is not used externally.) 



Physiological Action. 

1. On Nervous Function. 
— Long continuance in the 
use of potassic bromide tends 
to cause a sense of fatigue 
and general muscular pros- 
tration, with giddiness and 
staggering. 

Brain. — The functions of 
the brain are lessened, and 
sleep results. [Observation 
has shown that the bromides 
actually reduce the amount 
of blood in the brain.] 

Spinal Cord It has been 

proved by experiments on 
animals that the reflex irrita- 
bility of the cord is lessened, 
as indicated by the anaesthe- 
tic effect which is produced 
on the palate. 

It has also been observed 
that the power of voluntary 
movement persists after the 
abolition of reflex function, 



Therapeutical Action. 

1. Potassic bromide has 
gained great repute within 
the last few years in the 
treatment of a large series of 
convulsive and spasmodic af- 
fections, and most especially 
in epilepsy, it being now tho- 
roughly established that if we 
get our case sufficiently early 
we may absolutely cure it, 
and even if it is too confirmed 
for this result we may keep 
it in check. The cases most 
under the influence of the 
drug are those known as the 
haut mal, where violent strug- 
gling is followed by comatose 
sleep ; on the other hand, in 
the petit mal, where the at- 
tack is indicated merely by 
passing unconsciousness, or 
when the seizures occur prin- 
cipally at night, the remedy 
will frequently disappoint us. 



BROMIDE OF POTASSIUM, 



361 



proving that the influence of 
the drug is exerted probably 
either upon the afferent nerves 
or upon those portions of the 
cord which transmit the im- 
pulse from these nerves to the 
cells presiding immediately 
over motion. 

The recent experiments of 
Ringer and Masehead show 
that, in the frog, the reflex 
functions of the cord are at 
first abolished, voluntary 
movement being unimpaired, 
but that later on, the volun- 
tary functions also become pa- 
ralyzed. They point out that 
these symptoms are entirely 
due to the potash, as potassic 
iodide and potassic chloride 
cause the same symptoms, 
which are never observed after 
the administration of the bro- 
mide of sodi u m. Potassic bro- 
mide also lessens the irrita- 
bility of the sensory nerves. 

Sympathetic System Po- 
tassic bromide is supposed to 
have a sedative influence over 
the sympathetic system of 
nerves ; but on this point the 
evidence is very contradic- 
tory. 



31 



A New York committee of 
the Pathological Society, un- 
der the presidency of Dr. E. 
Seguin, have recently re- 
ported on a combination of 
potassic bromide with chloral 
in epilepsy, and praised its 
efficiency in arresting the pa- . 
roxysm, avoiding remission, 
and keeping up the general 
condition of the patient. 

When the remedy is act- 
ing well in epileptics, we will 
always readily detect a de- 
cided suppression of reflex 
sensibility (nausea) at the 
back of tongue and fauces. 

Potassic bromide is be- 
lieved to act in epilepsy by 
relieving the spasmodic con- 
traction of a vessel supplying 
a special vascular brain area 
which is thus deranged in 
function. 

It is also of great benefit in 
the various convulsive sei- 
zures of children in laryngis- 
mus stridulus, night terrors, 
and also in those spasmodic 
symptoms which depend on 
meningitis or organic brain 
disease. 

It is of service in incon- 
tinence of urine, pertussis, 
cramp of lower limbs, chorea, 
in delirium tremens, and in 
many of those forms of men- 
tal depression, nervous head- 
ache, and vague sensations, 
indicating nervous disturb- 
ance, which are so distressing 



362 



BROMIDE OF POTASSIUM. 



2. Effects on Circulation. 
— No special action on the 
heart has been observed save 
some slight lowering of its 
action. The smaller arteries 
are believed to be contracted, 
the pulse becoming smaller; 
and we may thus explain the 
hypnotic action of the drug, 
the brain being rendered anae- 
mic as in physiological sleep. 



3. Its influence on diges- 
tion is not marked ; for al- 
though it sometimes seems to 
lessen the appetite, this is not 
a constant result. 

4. The effects on the uri- 
nary secretion have not been 
thoroughly made out. 

5. Bromide of potassium 
has an undoubted influence 
over the generative organs, 
lowering their excitability, 
and even, in large doses, sus- 
pending their activity. 



to some women about the 
change of life. 

It is said to be a good 
remedy in sea-sickness, from 
the sedative effect on the 
centre concerned in the reflex 
act of vomiting. 

2. Bromide of potassium 
is an excellent narcotic, and 
causes refreshing sleep, more 
especially in cases of worry, 
mental anxiety, or overwork, 
a full dose being given at bed- 
time ; and in acute mania its 
use in combination with chlo- 
ral is highly praised by Clous- 
ton. It is said to heighten 
the action of opium, and less- 
en the occasional unpleasant 
symptoms of nausea, faint- 
ness, and giddiness. It has 
been found useful in dys- 
pepsia. 



4. It has been much prais- 
ed by Begbie in diabetes. 

5. It is useful in priapism, 
and in those forms of menor- 
rhagia which depend on ova- 
rian irritability. 



Potassium bromide is eliminated from the system by the 
urine, breath, sweat, and milk (a case being recorded in 
which the child of a suckling mother taking the salt, became 
covered with acne). Some authorities think infants specially 
susceptible to its action. 



bromide of potassium. 363 

Disadvantages and Contra-indications. 

We have already noted the peculiar nervous symptoms 
occasionally caused by pot. bromid. — giddiness, general mus- 
cular fatigue, even amounting to actual staggering in some 
cases. But in addition to this an unpleasant eruption of 
acne often breaks out on the face, and may arise from a very 
small dose. If, in spite of this, the remedy is persisted in, 
the whole body may eventually be covered with large and 
unsightly blotches, and boils, even rupial ulcers, have been 
observed. 

To prevent the bromide rash, we are advised to add a little 
liq. arsenicalis [Br.] to each dose, and we may remove the 
spots by the following lotion — 

1$.. Sulphuris praecip. 5iij I or 12 Gin. 

Spt. camphorse 5J I " 4 " 

Aq. calcis ad % iij ; " 96' " M. 

Ft. lotio. 

Apply morning and evening. 

Dose and Mode of Administration. 

The dose for epilepsy ranges from 10 to 60 grains, it being 
necessary to increase the quantity gradually, and continue 
its use for long periods, even years, occasionally leaving it 
off for a week or so, after which it seems to regain some of 
its lost effect. 

Dose as a hypnotic gr. xx ad xxx. In other cases about 
gr. xx as an average. Children bear it well, and we may 
give a child 2 or 3 grs. with good effect. As its taste is 
rather nauseous, we must disguise it thus — 



R,. Potassii bromidi gr. xxx ; or 2iGm. 

Syrupi aurantii f 5j ', " 4 " 

Aquse aurantii flori ad f§ij ; " 64 " 

Fiat haustus hora somni sumendus. 



R_. Pot. bromidi §j ; or 32 

Chloral, hydratis £ss ; " 16 

Aquse ^ viij ; (t 256 

Dose, 3J thrice a day. 



Gm. 



M. 



M. 



Or, give it simply dissolved in water. 

[A brominized solution of bromide of potassium has been 
recommended for laryngeal diphtheria or pseudo-membranous 
croup— 



364 



IODIDE OF POTASSIUM. 



R. 


Decocti "althese 


iii.i 5vj ; 


or 


120 




Potassii bromidii 


3J 


\ i 


4 




Bromini 


niv; 


a 






Syrupi simplicis 


f gviiss 


a 


30 



Gm. 



30 



Pose, f §ss every hour during urgent symptoms. 



M. 



For children under one year the quantity of bromine in 
the mixture should be reduced to 0.10 Gm., and for those 
from 1 to 4 years old to .20 Gm. 1 ] 

Potassii Iodidum — Iodide of Potassium. 
Constitutional Action. 



Physiological. 

1. On Brain and Nervous 

System No special action 

on the nervous system has 
been observed, unless we hold 
that the uncomfortable sen- 
sations of misery and depres- 
sion, occasionally following its 
use, may may be thus ex- 
plained. 



2. The effects of iodine on 
the circulation have never 
been properly estimated, but 
some observers say that it 
tends to contract the vessels 
and cause increased rapidity 
of the heart's action. Potas- 
sic iodide has very swift diffu- 
sive power, entering the blood 
very rapidly, being given off 
within ten minutes after in- 
gestion. 

3. On respiration and tem- 
perature no effects have been 
noted. 



Therapeutical. 

1. Iodide of potassium is 
of great service in many 
brain-diseases, and most es- 
pecially those in connection 
with tertiary syphilis, where 
gummata, and other forms of 
tumor, cause those excrutiat- 
ing pains and varying nerv- 
ous phenomena which have 
been so ably described by 
Drs. Broadbent and others. 

2. Potassic iodide has been 
used with great benefit by Dr. 
Balfour, Da Costa and others 
in aortic aneurism, several 
successful cases having been 
reported. It is difficult to 
explain the rationale of its 
action, but it is essential that 
large doses (twenty grains) 
be prescribed, to be repeated 
several times daily, and con- 
tinued regularly for a year or 
more. 



1 Redenbacher-iErtzlich.es Intelligensblatt, January 7, 1879. The 
Practitioner, vol. xxii. p. 208. 



IODIDE OF POTASSIUM. 



365 



4. Effects on secretion. 
a. Intestinal. — Nothing spe- 
cial save occasional loss 
of appetite and disorderd 
digestion. 
j3. Urinary. — Potassic iodide 
has some diuretic ac- 
tion, more especially in 
connection with other 
drugs. 
y. The salivary secretion is 
often markedly increas- 
ed, true salivation being 
sometimes produced. 
8. It is also believed that the 
iodide of potassium has 
some special action on 
glandular tissues in gen- 
eral, increasing- their 
absorptive powers, and 
even exciting them to 
absorb themselves ; and 
in support of this last 
proposition it has been 
stated that, under its use, 
the mammas and testi- 
cles have been observed 
to waste and disappear. 
This conclusion has pro- 
bably been arrived at, 
however, by confusing 
the post with the prop- 
ter hoc, and it is proba- 
ble that the remedy does 
not so much actually 
stimulate the absorbents 
as reduce effused lymph 
to a condition more fa- 
vorable for elimination. 
5. It also has the power of 
removing various metallic 
substances from the tissues, 
— mercury and lead, for in- 

31 



j3. Potassic iodide is occa- 
sionally used to heighten the 
diuretic action of other drugs. 



8. The iodide of potassium 
is often given to facilitate and 
hasten the absorption of in- 
flammatory lymph in the later 
stages of pleurisy, pneumo- 
nia, pericarditis, etc. 



5. In cases of chronic 
lead-poisoning, so often met 
in house-painters, or where 
we wish to remove mercury 



366 



IODIDE OF POTASSIUM. 



stance, being occasionally de- 
posited in the form of an in- 
soluble albuminate, and .re- 
leased from this condition by 
the action of the drug. 



6. Finally, this salt has an 
irritating action on mucous 
membranes, causing redness, 
tingling, and free secretion, 
resembling much an ordi- 
nary catarrh, and also thin- 
ning and liquefying tena- 
cious, morbid, mucoid secre- 
tions. 

7. There are other import- 
ant uses of potassic iodide 
which cannot be arranged 
under the preceding catego- 
ries, and which must there- 
fore be called specific. These 
are its influence over syphi- 
lis, gout, chronic rheumatism, 
and simple periostitis. 



from the system, we generally 
prescribe potassic iodide, and 
in the latter case we must not 
be surprised if our patient is 
suddenly seized with profuse 
salivation. This is explained 
by the released mercury find- 
ing its way back into the cir- 
culation, and exerting its 
usual influence on the salivary 
glands. 

6. Potassic iodide is often 
prescribed in cases of bron- 
chitis where the expectoration 
is thick, tenacious, and diffi- 
cult of expulsion, and it here 
acts well by thinning the 
sputa. 



7. In cases of tertiary 
syphilis, this salt often acts 
like a charm. In the pri- 
mary and secondary forms, 
it is of little or no use, but 
when the deeper tissues begin 
to be affected, and when we 
meet with deep rupial or 
other ulcerations of the skin, 
ulcers in the throat, perios- 
titis, and head symptoms, we 
may then prescribe iodine 
with the certain expectation 
of relief. In chronic gout it 
is also of service, and in chro- 
nic rheumatism, more espe- 
cially in those cases, where 
we meet with tenderness to 
pressure and nocturnal in- 
crease of pain. In simple 
periostitis of the skull, ster- 
num, or tibia, which often 
results from exposure to cold, 



IODIDE OF POTASSIUM. 367 

iodide of potassium has an 
almost magical effect, and 
will often bring about a cure 
after two or three days' 
treatment. 

Potassic iodide is eliminated from the body by the urine, 
saliva, tears, milk, etc. ; it can be detected in the urine in 
ten minutes after being swallowed, and it is rapidly given 
out, so that the whole may be recovered from the various 
secretions. 

Disadvantages and Contra-indications. 

As regards its disadvantages and contra-indications, we 
must remember the possible occurrence of iodism, to which 
unpleasant symptom some persons are much more susceptible 
than others. These consist, in the first place, of irritation 
about the mucous membranes, running at the eyes and nose, 
sneezing, frontal headache, swelling of the eyes, and saliva- 
tion ; an eruption not unlike nettle-rash is sometimes observed ; 
occasionally acne maybe the result, and Ringer and Fournier 
have described a peculiar petechial eruption affecting the 
legs. Quite recently Mr. J. Hutchinson has expressed his 
belief that the formidable pustular eruption known as hydroa 
is really caused by iodide of potassium, but in my own expe- 
rience and that of others who have freely prescribed the 
drug, these various uncomfortable effects are comparatively 
seldom observed, a curious point being that iodism seems to 
be much more readily excited by small than by large doses 
of the drug. Tilbury Fox describes (Clin. Soc. Trans., 
1877) two forms of eruption, one an acneiform rash, devel- 
oping into bullae which occasionally burst, forming fungoid 
masses from the size of a pea to a shilling, and quite distinct 
from hydroa, being really a modified form of acne produced 
by stimulation of the sebaceous glands. The second was 
vesicular in character. 

Mr. James Lane (Harveian Lectures) gives the result of 
a large experience in the treatment of syphilis, and advises 
us to begin with small doses, 3 or 4 grains until 15 or 30 
grains (.20 to 2. Gm.), are reached. If it causes much 
irritation, we may substitute the iodide of sodium. 

In some persons a good deal of depression and digestive 
derangement is caused. 



368 IODIDE OP POTASSIUM. 

To Prevent Iodism. 

Some few years ago, Sir James Paget observed that the 
addition of spiritus ammonia? aromat. to potassic iodide 
not only lessened the chances of iodism, but enabled us to 
limit ourselves to a smaller dose, and this has come very 
generally into use. 

Dose and Mode of Administration. 

[The iodide of potassium should be prescribed alone, or 
only in combination with other preparations of iodine, or 
with corrosive sublimate. (See page 32.) 

This salt may be given simply dissolved in water, or its 
taste may be well disguised by administering it in combina- 
tion with compound syrup of sarsaparilla, or compound infu- 
sion of gentian.] 

Potassic iodide as an antisyphilitic may be given in doses 
of from 3 to 30 grains, or even 60, according to the judgment of 
prescribers, it being necessary in obstinate cases to push the 
drug very freely. 

[Dr. Taylor, at the meeting of the American Dermatolo- 
gical Association, said- that patients would tolerate an ounce 
and a half daily and grow fat on it, the only physiological 
result being increased urination. He mentioned a case of 
nodes, where fourteen drachms daily were administered ; 
nothing less would give the patient relief at night. He 
thought that in similar cases the addition of bromide of 
potassium, one drachm to seven of the iodide, would be of 
advantage. 

He also remarked that he had observed pains in the joints 
occasionally, even when small doses of iodide were being 
administered, which were considered as being due to the 
remedies employed. He offered a practical suggestion in 
reference to the prevention of these pains (which are diurnal 
and not nocturnal), which was that tincture of colchicum 
and tincture of hyoscyamus, combined with small doses of 
the iodide of potassium, would obviate them. Occasionally 
it is necessary to use camphorated oil, or some warming 
application externally. The joint trouble is sometimes poly- 
articular, sometimes mon-articuJar.] 

Professor Syme, however, used to say that all good effects 
can be obtained by two or three grains, and in ordinary 



PRUNES — POWDERS, 369 

cases of syphilis or periostitis, rheumatism, etc., this would, 
in his opinion, be found a sufficient dose, copious dilution 
aiding its effects. 

In aneurism we must give at least twenty grains, and in 
advanced syphilitic affections even larger doses are well 
borne. 



1$. Potassii iodidi gr. xl ; or 2 

Spiritus aramonise aromatici f §ss ; " 16 

Syrupi aurantii f §i ; " 32 

Decocti sarsaparillse compositi ad f §viij. " 256 

S. Capiat unciam unam ter in die. 



60 Cm. 



M. 



PRUNUM—PRUNES. 

[ The dried fruit of Primus domestica, U. S. 

Enters into Confectio Sennas.] 
Prunes are slightly purgative. 



[PRUNUS VIRGINIANA— WILD CHERRY. 

The bark of Cerasus Serotina (De Candolle), U. S. 

Officinal Preparations, U. S. 

Extr actum Pruni Virginians Fluidum. Dose, 

f 3J (4. 6m.). 

Infusum Pruni Virginian®. Dose, f Jij-iij (64. 
to 96. Gm.). 

Syrupus Pruni Virginian®. Dose, f £ss (16. Gm.). 

Wild cherry bark is tonic and sedative, the freshly pre- 
pared preparations containing a small amount of hydrocyanic 
acid. The syrup, from its pleasant flavor, is much used as 
an ingredient in cough syrups for phthisis, or chronic 
bronchitis.^ 



[Pulveres. 

The officinal Powders are — 

Pulveres Effervescentes.— Soda, or effervescing powders. 

" Aperientes. — Seidlitz powders. 

Pulvis Aloes et Canellse. — Hiera Picra (holy bitter). 

" Aromaticus. — Spice powder. 

" Ipecacuanhse Compositus. — Dover's powder. 

" Jalapre Compositus. — Jalap and cream of tartar. 

" Rhei Compositus. — Rhubarb, magnesia, and ginger.] 



370 



POMEGRANATE — QUASSIA. 



PUNICA GR AN ATUM— POMEGRANATE. 

[Granati Fruetus Cortex. The rind of the fruit of 
Punic a Granatum, U. S. 

Granati Radicis Cortex. The bark of the root of 
Punica Granatum, U. £.] 



Physiological Action. 

Pomegranate bark destroys 
a tape-worm, according to 
Kiichenmeister, in three 
hours. [As it contains gallo- 
tannic acid, it should not be 
prescribed in combination 
with metallic salts. It may 
be given in the form of the 
fluid extract (not officinal), or 
it may be used in decoction 
(o'j to Oj), as an astringent 
wash.] 



Therapeutical. 

It is much used as an an- 
thelmintic in veterinary prac- 
tice [and is sometimes given 
in infusion as a gargle, and 
as an injection in gonorrhoea. 
A tape-worm may be dis- 
charged in a few hours by 
administering the decoction 
through a stomach tube, and 
following it by castor oil.] 



QUASSIA— QUASSIA. 

[ The ivood of Simaruba excelsa, U. S. 
Officinal Preparations, U. S. 

Extraetum Quassise. Dose, gr. j-iij (.06 to .20 
Gm,). 

Infusum Quassias (3ij to Oj). Dose, f|j-ij (32. to 
64. Gm.). 

Tinetura Quassias (5j to Oj). Dose, gtt. xx-f*3j 
(1.30 to 4. Gm.).] 



Physiological Actions. 

The action of quassia is 
directed to the gastrointes- 
tinal mucous membrane, and 
it is probable that its in- 
tensely bitter taste may stim- 
ulate the secretion of gastric 
juice, as it certainly increases 
the appetite. 



Therapeutical Actions. 

Quassia is much used as a 
tonic in dyspepsia, want of 
appetite, and general debility. 
Having no aromatic flavor, it 
is sometimes badly borne by 
weak stomachs, but, being 
very cheap, it is largely pre- 
scribed in dispensary prac- 
tice, more especially in com- 
bination with iron. 



OAK — RESIN. 371 

Quassia is destructive to It is therefore of service, 
many of the lower forms of given as an enema, for the 
animal life. destruction of thread-worms. 



QUERCUS— OAK. 

[Quereus Alba. The inner bark of Quercus alba, U. S. 
Quereus Tinetoria. The inner bark of Quercus 
tinctoria, U. S. 

Officinal Preparation, U. S. 

Decoetum Quereus Alba (gj to Oj). Dose, fjiv 
(128. Gm.).] 

Oak bark contains tannic and gallic acids, and the decoc- 
tion is therefore of some value as an astringent in relaxed 
throat, leucorrhoea, etc. 



[RESINA— RESIN. 

The residue after the distillation of the volatile oil from the turpentine of 
Pinus palustris, and of other species of Pinus, U. S. 

Ceratum Resin®. 

Ceratum Resin® Compositum. 

Emplastrum Resin®. 

Enters into Ceratum Cantharidis, Ceratum Extracti 
Cantharidis, Ceratum Sabinae, and Emplastrum Hydrargyri. 

Has no great therapeutic interest, except in its pharma- 
ceutical relations. It has been recommended in five grain 
doses for chronic diarrhoea, but is seldom used internally.] 



[Resin®. 

The officinal Resins are — 

Resina Jalapse Resina Scammonii.] 

' ' Podophylli 



[Oleo-resin®. 

The officinal Oleo-resins are — 

Oleo-resina Capsici Oleo-resina Lupulinse 

" Cubebse " Piperis 

" Filicis " Zingiberis.] 



372 RHUBARB 



RHEUM—RHUBARB. 

[ The root of Rheum palmatum, and of other species of Rheum, from 
China, Chinese Tartar}/, and Thibet, U. S. 

Officinal Preparations, U. S. 

Extraetum Rhei. Dose, gr. x-xxx (.65 to 1.30 
Gm.). 

Extraetum Rhei Fluidum. Dose, gtt. x-xxv (.65 
to 1.60 Gm.). 

Infusum Rhei (3iv to Oj). Dose, f*ij-iv (64. to 
128. Gm.). 

Pilule Rhei (each, gr. iij). Dose, 4 to 8 pills. 

Pilula^ Rhei Composite (Rhei gr. ij, aloes gr. iss). 
Dose, 2 to 4 pills. 

PulviS Rhei Compositus (Rhubarb %iv ; magnesia 
^xij ; and ginger 3ij). Dose, 3 ss- j (2. to 4. Gm.). 

Syrupus Rhei (,f iss to Oj). Dose, fgss-j (16. to 32. 
Gm.). 

Syrupus Rhei Aromatieus (5yf to Oj). Dose, for 
infant, f^j (4. Gm.). 

Tinetura Rhei (3 iss to Oj). Dose, f^ss-j (16. to 32. 
Gm.). 

Tinetura Rhei et Sennae (gj to Oj). Dose, fgss-j 
(16. to 32. Gm.). 

Vinum Rhei (gij to Oj). Dose, f3j-iv (4. to 16. 
Gm.).] 

Constitutional Action. 

Physiological. Therapeutical. 

Like castor oil, rhubarb The astringent action of 
combines some astringent rhubarb renders it most use- 
properties with its undoubted ful in those forms of diar- 
cathartic effects ; and whilst rhcea depending on the pre- 
the first mentioned action is sence of indigestible matters 
no doubt due to the tannin in the alimentary canal, and 
which it contains, investiga- where removal of the exciting 
tors have not yet determined cause, followed by rest of the 
on what special ingredient irritated intestine, is suffi- 
its purgative powers depend, cient to effect a cure. 

When taken in consider- It is a good tonic in some 

able closes, it not only stimu- cases of dyspepsia, and forms 



ROSE. 



373 



lates the peristaltic move- 
ments of the small intestine, 
and more especially the duo- 
denum, but it moistens and 
softens the feces, and in- 
creases most decidedly the 
secretion of bile. 



a good purgative for children, 
more especially when com- 
bined with magnesia, as in 
the well-known Gregory's 
Powder [pulv. rhei comp.]. 

Prof. Rutherford's experi- 
ments on its cholag-ogue ac- 
tion would indicate its em- 
ployment in jaundice and 
deficient secretion of bile. 



The chrysophanic acid, or yellow coloring matter of 
rhubarb, is readily absorbed, and rapidly given out by the 
intestines, milk, sweat, and urine, to which latter secretion 
it imparts a yellow tinge, turning red on the addition of an 
alkali. [For use of chrysophanic acid in skin diseases, see 
Goa Powder in the succeeding section.] 

Dose, Mode of Administration, etc. 

The smell and flavor of rhubarb are excessively nauseous, 
and, although we cannot effectually disguise either, we may 
at least render the drug moderately palatable by the follow- 
ing formulae : — 

R. Infusi rliei f^ij ; or 64 Gra. 

Potassii bicarbonatis ^j ; " 4 

Tincturae cmnamorni f £ij ; " 8 

Syrupi simplicis f 5yj ; " 24! " M. 

Dose, f3j secunda qufique liora. 

In the diarrhoea of children. 

R. Pulveris rhei 

Sodii bicarbonatis 

Spiritus myristicae 

Syrupi zingiberis 

Aquae menthae piperita? adf^iss; 48 " M. 

Misce, fiat liaustus nocte sumendus 

Antacid and purgative 

ROSA— ROSE. 

[Rosa Centifolia. The petals of Rosa centifolia, JJ. S. 
Rosa Galliea. The petals of Rosa Gallica, U. S. 
Oleum Rosffi. The volatile oil obtained from the petals 
of Rosa centifolia, U. S. 
32 



gr. xxx ; 


or 


2 


Gm 


gr. xv ; 


i i 


1 


i i 


ui xxx ; 


( t 


2 


n 


f 5 j ; 


a 


4 


n 


ad f §iss ; 
lmendus. 


ki 


48 


a 



374 ROSEMARY — BLACKBERRY. 

Officinal Preparations, U. S. 

Aqua Rosae (Rosa centifolia). As a vehicle. 
Confectio Rosae. As an excipient for pills. 
Infusum Rosae Compositum (containing sulphuric 
acid). As a vehicle. 

Mel Rosae. As a vehicle. 

Syrupus Rosae Gallicae. As a vehicle. 

Unguentum Aquae Rosae (cold cream). 

Also enters into Piluke Aloe's et Mastiches, and Syrupus 
Sarsaparillre Compositus.] 

The various preparations of roses have little therapeutical 
significance. The cabbage-rose is used in the form of rose- 
water as an elegant vehicle ; the red-rose petals as confection 
constitute a convenient basis for a pill mass, whilst, com- 
bined with sulphuric acid in the acid infusion, they make an 
excellent gargle, either alone or with alum, whilst they may 
occasionally be of service in concealing the nauseous flavor 
of sulphate of magnesia. 

Hips [dog-rose, rosce canince fructus, Br.] are also slightly 
astringent. 



ROSMARINUS— ROSEMARY. 

[ The leaves of Rosamarinus officinalis, U. S. 

Oleum Rosmarini. Used in perfumery. 

Is rarely used in this country except as a perfume.] 

Rosemary, lavender, and peppermint are agreeable car- 
minatives, much used in combination with other stimulant 
drugs. 



[RUBUS— BLACKBERRY. 

The bark. of the root of Rubus Canadensis and of Rubus villosus, U. S. 

Officinal Preparations, U. S. 

Extraetum Rubi Fluidum. Dose, f 3ss (2. Gm.). 
Syrupus Rubi. Dose, t"3j-ij (4. to 8. Gm.). 

Much prized as a tonic and astringent, and particularly 
adapted to the diarrhoea of relaxation. A decoction is also 
made in domestic practice (Jj to Oiss, boiled down to a pint), 



RUE — CEVADILLA. 315 

of which f gj-ij (32. to 64. Gra.) may be given three or four 
times daily.] 



[RUTA—RUE. 

The leaves of Ruta Graveolens, U. S. 

Oleum RutaB. Dose, gtt. iij-vj (.20 to .40 Gm.). 

Rue is stimulant, and, in large doses, is an acro-narcotic 
poison. Moderate doses have some emmenagogue effects, 
and, in cases of poisoning, miscarriage generally occurs.,] 



SABADILLA— CEVADILLA. 

[ The seed of Veratrum Sabadilla (Retziiis), U. S. 

Officinal Preparations. 

Veratria. Not used internally. 
Unguentum Veratria^ (gr. xx to gj). 

Poisoning. 

In directly fatal doses, veratria depresses the whole nervous 
system ; the respiration and circulation are gradually sus- 
pended ; the convulsive movements, noticed under smaller 
doses, now pass into tetanus, the rigidity of the muscles of 
the chest impede respiration, and death takes place by as- 
phyxia (Dr. Stille). 1 

Antidotes. 

Vegetable astringent infusions, containing tannic acid, 
should be freely administered, the stomach washed out, fol- 
lowed by stimulants and an opium suppository, or enema. 
Tincture of digitalis would seem to be a physiological anti- 
dote. Whiskey may be given hypodermically on the approach 
of collapse.] 

External Actions. 

Physiological. Therapeutical. 

The application of vera- Veratria has been used 
tria to the skin causes first with success as a local appli- 

1 [National Dispensatory, Philada., 1879, p. 1478.] 



376 CEVADILLA. 

pricking and tingling, fol- cation in cases of neuralgia 

lowed by redness and acute of the fifth nerve, but its irri- 

darting pain. To this sue- tating properties must always 

ceeds numbness, due, in all be a barrier to its extensive 

probability, to some local employment. [The officinal 

anaesthetic influence on the ointment generally requires 

extremities of the sensory dilution -J to f. When used, 

nerves. care should be taken not to 

The slightest contact of rub the eyes with the greasy 

veratria with the nasal mu- fingers, as violent irritation 

cous membrane causes vio- may result.] 
lent irritation and prolonged 
sneezing. 

Internal Actions. 

Veratria is never used internally in this country. 

Brain and Nervous System No action on the brain. 

Spinal Cord A good deal of elaborate, but unfortunately 

contradictory, experimental evidence has been adduced by 
various observers with reference to the effects of veratria on 
voluntary movement. In the first place convulsions and 
even tetanic spasms may be produced by the administration 
of the drug, but these are speedily followed by paralysis and 
complete muscular prostration ; and the balance of testimony 
goes to show that this is due to a primary exciting and 
secondary paralyzing action on the muscular structures 
themselves. 

Heart and Circulation Veratria first increases the action 

of the heart by stimulating its motor ganglia, but^secondary 
slowing and depression rapidly ensue from an exciting action 
on the vaofi. 

Respiration is at first quickened, but subsequently retarded 
by the lowering effect of the drug on the respiratory centre. 
The temperature of the body falls. 

Digestive and Secreting Organs. — Veratria often causes 
troublesome vomiting and purging. 



SAVINE — SUGAR. 377 

SABINA— SAVINE. 

[ The tops of Juniperus Sabina, U. S. 
Dose, in substance, gr. v-xv (.30 to 1. Gra.). 

Officinal Preparations, U. S. 
Ceratum Sabinae (fluid extract, f^iij ; resin cerate, 

Extraetum Sabinae Fluidum. Dose, gtt. v-xv 
(.30 to 1. Gm.). 

Oleum Sabinae. Dose, gtt. ij-v (.12 to .30 Gm.).] 

Local Effects. 

Savin used to be applied in the form of ointment to blis- 
tered surfaces, with the view of encouraging suppuration, 
but this barbarous process is now happily abandoned. [It 
is stimulant and rubefacient, and is sometimes applied to 
warts, ulcers, and diseases of the scalp.] 

Internal Uses. 

Physiological. Therapeutical. 

Savin is a gastro-intestinal Savin is sometimes used 

irritant, causing in large with criminal intent to pro- 
doses vomiting and purging ; cure abortion, and death has 
and it has also a powerful occasionally resulted from its 
stimulating influence on the irritant action. It is rarely 
uterus. used in medicine, although 

some anthorities express faith 
in its emmenagogue powers. 



SACCHARUM— SUGAR. 

[ The sugar of Saccharum officinarum, refined, U. S. 

SYRUPUS FUSCUS— MOLASSES. 

The impure, dark-colored syrup, obtained in making sugar from 
Saccharum officinarum, U. S. 

Officinal Preparations. 

Sugar enters into Pilula Ferri Carbonatis, Pilulae Ferri 
Iodidi, and the various svrups.] 

32* 



3T8 SUGAR OF MILK — ELDER. 

Sugar is principally used in the form of syrup as a flavoring 
adjunct. [Molasses is laxative ; and molasses candy forms 
a good substitute for more active remedies in treating con- 
stipation in children.] 



SACCHARUM LACTIS— SUGAR OF MILK. 

\_A crystalline substance obtained from ivhey, U. S.~\ 

Milk, and sugar of milk, have no special therapeutical pro- 
perties apart from their nourishing qualities. 



[SAGO— SAGO. 

The prepared fecula of the pith of Sagus Rumphii, and other 
species of Sagus, U. S. 

Used, like arrowroot, as an article of diet for the sick, 
thoroughly boiled in water or milk (a tablespoonful to a pint) 
and flavored with sugar, lemon, spice, or wine, according to 
taste.] 



[SALVIA—SAGE. 

The leaves of Salvia officinalis, U. S. 
Officinal Preparation, U. S. 

Infusum Sal vise (^ss to Oj). Used as a gargle. 

Sage is tonic, astringent, and aromatic. It has been used 
as a carminative in debility of the stomach with flatulence, 
and the infusion is a useful gargle, to which honey, alum, 
or vinegar may be added, but it strikes a black color with 
iron (it contains tannic acid). A weak. infusion is sometimes 
used as a drink in fevers to allay nausea.] 



SAMBUCUS— ELDER. 

[ The flowers of Sambucus Canadensis, U. S. ] 

Only used in the form of aquas sambuci [Br.], which is a 
cooling and pleasant lotion. [The root of Sambucus nigra 
(common, black elder-berry) acts as a hydragogue cathartic. 
The expressed juice of the root may be given in doses of 
^j-ij until salivation, vomiting, and purging occur; or a 
decoction may also be made.] 



BLOODROOT — SANTONICA. 379 

SANGUINARIA—BLOODROOT. 

[ The rhizome of Sanguinaria Canadensis, U. S. 

Officinal Preparations, U. S. 

Aeetum Sanguinariae (§ij to Oj). Dose, r^xv-xxx 
(1. to 2. Gm.). 

Tinetura Sanguinariae (|ij to Oj). Dose, gtt. xx- 
xl (1.30 to 2.60 Gm.).] 

This is a substance of energetic physiological properties, 
causing clonic convulsions of spinal origin, diminishing 
reflex action, weakening the force of the heart, and lessen- 
ing arterial tension, lowering the temperature, dilating the 
pupil, and finally causing death by respiratory paralysis. It 
also possesses violent emetic properties, and stimulates he- 
patic secretion. It has been used more especially in America, 
and has been found useful in atonic dyspepsia and duodenal 
jaundice, in chronic catarrh, and some stages of bronchitis, 
and may be given in doses of 5 to 10 minims of the tinc- 
ture three times a day. [The powdered root has been used 
as a stimulant in indolent ulcers, which has led some to con- 
sider it a specific for cancer I'] 



[SANTALUM— RED SAUNDERS. 

The ivood of Pterocarpus santalina, U. S. 

Used only in pharmacy as a coloring agent, and enters 
into Spiritus Lavandulae Compositus.] 



SANTONICA— SANTONICA. 

[ The unexpanded flowers of Artemisia Cina. ( Willkomm Botanische 
Zeitung, 1872, No. 9), U. S. 

Officinal Preparations, U. S. 

Santoninum. Dose, gr. ss-iij (.03 to .20 Gm.). 
Troehisci Santonini (each, gr. ss).] 

Local Action. 
Santonin has no local action. 



380 



SANTONICA. 



Internal Actions. 



Physiological. 

I. Brain and Nervous Sys- 
tem — It is no doubt due to 
some influence on the brain 
that the peculiar derange- 
ment of vision which is some- 
times found accompanying 
the use of santonin, de- 
pends ; as no staining of the 
ocular media has been ob- 
served, and slight hyperemia 
of the retina is the only ap- 
parent local effect. Some 
observers note the first stage 
to be an exaggerated appre- 
ciation of the violet rays of 
the spectrum, but the most 
evident alteration in sight 
consists in very distinct yel- 
low vision, all white objects 
being seen in a more or less 
pronounced saffron tinge, 
which begins about half an 
hour after the drug is swal- 
lowed. Associated with this 
we find a diminished or even 
abolished appreciation of the 
violet rays of the spectrum. 
A good deal of lassitude and 
mental depression usually 
follows the use of this medi- 
cine, and it must be cau- 
tiously pushed, as large doses 
have occasionally proved 
fatal from tetanic spasms and 
convulsions and coma. 

II. Respiration and Cir- 
culation No special influ- 
ence on these functions 'has 
been noted. [In poisoning 



Therapeutical. 



I. Santonin has been ' re- 
commended as a remedy for 
some affections of the optic 
nerve, but no trustworthy 
evidence has yet been adduced 
of its efficacy. 



Santonin has not been used 
in any form of nerve disease, 
but it seems at least possible 
that it might prove of service 
in some forms of so-called 
color-blindness. 



SANTONICA. 



381 



there is accelerated and 
feeble pulse and rapid respi- 
ration.] 

III. Secreting Organs — 
Slight digestive disturbance 
is usually experienced, indi- 
cated by nausea, headache, 
and general malaise. 



Urinary Organs. — Re- 
markable effects* are here 
noted, consisting of a bright 
yellow coloration of the 
urine, beginning five min- 
utes after a few grains have 
been swallowed, persisting 
for two or three days, and 
communicating a stain to 
linen, as in the case of jaun- 
dice. Should the urine hap- 
pen to be alkaline, the color 
assumes a blood-red tinge, 
and the same change fol- 
lows the addition of ammo- 
nia to the acid secretion. 
At the same time the flow 
of urine is increased, the pa- 
tient experiences an irresist- 
ible desire to micturate, and 
in the case of children this 
may even give rise to com- 
plete temporary incontinence. 



III. The real use of san- 
tonin in practice consists in 
its effect on the round worm, 
or ascaris lumbricoides, 
which it speedily destroys. 
It appears to have no influ- 
ence over the tape-worm, 
and it is an open question 
with regard to its service in 
cases of ascaris vermicularis. 



Santonin has been recom- 
mended as a remedy for in- 
continence of urine, and is 
said to succeed occasionally 
in cases of this troublesome 
affection after other remedies 
have failed. 



Mode of Elimination. 

Santonin is supposed to combine with the soda in the 
blood, and to be given out, in part at least, by the urine. 



3S2 soap. 

Cautions. Mode of Administration. 

[Prof. Binz has related a case of santonin-poisoning in 
which, apparently, a small close produced serious symptoms. 
Two lozenges, containing less than a grain, were followed, 
10 hours afterwards, by a convulsive attack which recurred 
several times during the next few days. The child never 
had convulsions before. It would seem as if the troches 
must have contained more of the drug than was sus- 
pected. 1 ] 

As already observed, serious symptoms have been observed 
to follow the use of santonin, and we shall do well to warn 
our patients of the urinary irritability which is invariably 
experienced in greater or less degree. Dr. Sieveking has 
also drawn attention to the occurrence of grticaria following 
the administration of santonin, and Drs. Dyce and Ogson 
have given a suggestive hint by pointing out that its long- 
continued use causes the development of cataract in young 
animals. 

[When retained in the system santonin becomes converted 
into xanthopsia,, which appears in the urine. Poisonous 
symptoms are produced by this new substance, and they may 
be prevented by combining the santonin with an antacid 
and purgative, and in practice it is found that they are 
never produced when the santonin is combined with calomel, 
and soda.] 

Its taste is not unpleasant, but as it is insoluble in water 
it may be mixed with jam or treacle, or simply sprinkled on 
bread and butter [or preferably, in the officinal lozenge]. 



SAPO— SOAP. 

[Soap made with soda and olive oil, U. S. 
Officinal Preparations, U. S. 

Ceratum Saponis. 
Emplastrum Saponis. 
Linimentum Saponis. 
Pilule Saponis Composite. 

Enters into Extractum Colocynthidis Compositum, Pilulas 
Aloes, Pil. Aloes et Assafcetidse, Pil. Assafoetidae, Pil. 

» [Phil. Med. Times, Aug. 1877, p. 551.] 



SARSAPARILLA. 383 

Opii, Pil. Rhei, Pil. Rhei Composite, and Pil. Scillce 
Composite.] 

Soap is not applied to any therapeutical purpose, except 
the hard variety, which enters into the construction of some 
pill masses, and both the hard and soft aid in the construc- 
tion of liniments and plasters. 

[Soft, or potassa-soap, sometimes termed green soap, sapo 
viridis, has been recommended by Hebra in alcoholic solu- 
tion, under the name of spiritus saponis kalinis (2 pts. 
soap, 1 pt. alcohol), in the treatment of chronic eczema.] 



SARSAPARILLA— SARSAPARILLA. 

\_The root of Smilax officinalis {Humboldt and Bonplandt), and of other 
species of Smilax, U. S. 

Officinal Preparations, U. S. 

Decoctum Sarsaparillae Compositum (sarsapa- 
rilla, sassafras, guaiac, mezereon, and liquorice). Dose, 
f^iv (128. Gm.). 

Extractum Sarsaparillae Fluidum. Dose, f5ss 
(2. Gm.). 

Extractum Sarsaparillae Compositum Flu- 
idum. Dose, f5j (4. Gm.). 

Syrupus Sarsaparillae Compositum (giv to Oj). 
Dose, fgss (16. Gm.).] 

Internal Actions. 

Physiological. Therapeutical. 

Sarsaparilla has been ere- Nor is it easier to give 
dited with diaphoretic, diu- any decided opinion regard- 
re tic, and other powers ; but ing its therapeutical merits ; 
none of these have stood the for whilst some surgeons, 
test of rigid investigation, like the late Mr. Syme, hold 
and it is difficult to find any it to be quite useless, others 
convenient heading under believe it to be of service 
which to class this popular in constitutional syphilis, 
drug, unless Ave shelve the chronic skin disease, etc. 
difficulty by calling it an One point of difficulty in ar- 
" alterative." riving at any decided con- 
clusion is, that it is usually 



384 SASSAFRAS — SCAMMONY. 



prescribed along with three 
other drugs in the compound 
decoction ; but the late Mr. 
Gascoyne used to say that he 
had found great benefit in 
the treatment of the tertiary 
forms of syphilis by giving 
full doses of the freshly made 
infusion. 



SASSAFRAS— SASSAFRAS. 

[ The bark of the root of Sassafras officinale, U. S. 

Sassafras Medulla. The pith of the stems of Sassa- 
fras officinale, U. S. 

Oleum Sassafras. Dose, gtt. ij-x (.12 to .Go Gm.). 

Officinal Preparation, U. S. 
Mueilago Sassafras Medullae (5ij to Oj). 

Enters into Extractnm Sarsaparilhe Compositum Fluidum, 
and Decoctum Sarsaparillse Compositum.] 

This plant seems only to have acquired any therapeutic 
importance by reason of its combination with other drugs 
in the decoctum sarsaparilloe comp. The mucilage may be 
used as a soothing application in conjunctivitis. [The oil 
is a pleasant flavoring substance, and is considered carmina- 
tive.] 



SCAMMONIUM— SCAMMONY. 

[A resinous exudation from the root of Convolvulus Scammonia, U. S. 
Dose, in substance, gr. v-xv (.30 to 1. Gm.). 

Officinal Preparations, U. S. 

Hesina Seammonii. Dose (given in milk), gr. iv-viij 
(.25 to .50 Gm.). 

Extractum Coloeynthidis Compositum. Dose, 
gr. v-xxx (.30 to 2. Gm.).] 



SQUILL. 



385 



Physiological. 

Scammony causes a good 
deal of irritation of the ali- 
mentary canal, and produces 
copious watery stools, often 
attended with griping. For 
its proper action, previous 
solution in the bile, and com- 
bination with its soda, are 
requisite. 



Internal Effects. 

Therapeutical. 



Scammony is a purgative 
used in cerebral and dropsical 
affections ; and, being com- 
paratively tasteless, it is well 
adapted for children, forming 
a convenient purgative for 
the removal of ascarides. 



SCILLA— SQUILL. 

[ The bulb of Scillce maritima, U. S. 
Dose, in substance, gr. ij (.12 Gm.). 

Officinal Preparations, U. S. 

Acetum Scillse (gij to Oj). Dose, n^x-xx (.65 to 
1.30 Gm.). 

Syrupus Scillse. Dose, f^ss (2. Gin.). 

Pilulae Seillae Compositse (Squill gr. ss., ammoniac 
and ginger each gr. j). Dose, 3 to 5 pills. 

Syrupus Scillse Compositus (Tartar emetic gr. j in 
f Jj). Dose, gtt. x-f'5j (.65 to 4. Gm.). 

Tinetura Scillse (§ij to Oj). Dose, n^x-xx (.65 to 
1.30 Gm.). 

Extraetum Scillse Fluidum. Dose, n^ij-iij (.12 to 
.20 Gm.).] 



Internal 
Physiological. 

In large doses, squill may 
act as an emetic, and cause 
violet vomiting with purging. 

It also stimulates the bron- 
chial mucous membrane, and 
increases the urinary secre- 
tion. 

33 



Effects. 

Therapeutical. 

Squill is never used as an 
emetic [except, in its combi- 
nation with tartar emetic as 
"HiveSyrup"(Syrupus Seillae 
Compositus), which has been 
recommended in spasmodic 
croup. It may be repeated 



386 



BROOM. 



at short intervals, until 
vomiting occurs]. 

It is, however, a good ex- 
pectorant, increasing the 
bronchial secretions, and is 
one of the most universal 
additions to prescriptions for 
the relief of various chronic 
lung affections, as bronchitis, 
and also in whooping-cough. 

It is also a tolerably effi- 
cient diuretic, only to be 
used, however, when no irri- 
tation exists about the kid- 
neys. 



SCOPARIUS— BROOM-. 

[ The tops of Sarothamnus Scoparius (Wimmer), U. S."] 

Local Effects. 
No local action has been described. 



Constitutional Actions. 



Scoparius has some influ- 
ence over the digestive and 
secreting organs, causing, in 
large doses, vomiting and 
purging, but in smaller in- 
creasing very considerably 
the urinary water. Two 
active principles have been 
extracted from the drug, re- 
garding whose physiological 
actions some difference of 
opinion exists. Thus scopa- 
ejn is believed by one class 
of observers to be the diu- 
retic factor in broom-tops, 
whilst others assert that it 
has no such property. Spar- 
tein has also been very va- 



Scoparius is an excellent 
diuretic, and is largely used 
for the purpose of removing 
dropsical accumulations. If 
we can succeed in stimulating 
the kidneys effectually by a 
combination of this and other 
drugs, we may hope to hold 
in check and disperse the 
anasarca of cardiac and 
chronic kidney-disease, and 
to aid the removal of the 
watery fluid of hydrothorax 
and ascites. [An infusion of 
scoparius (^j to Oj), in con- 
junction with purging by 
compound jalap powder, is 
often used in cardiac dropsy, 



SENEKA. 



387 



to relieve an overloaded right 
side of the heart, with mitral 
insufficiency.] 



riously described, but the 
balance of testimony goes to 
show that it has very definite 
toxic powers, lowering the 
reflex action of the spinal 
cord, paralyzing the motor 
nerves, suspending the elec- 
trical excitability of the va- 
gus, and finally causing death 
by respiratory paralysis. 



Dose and Mode of Administration. 

Scoparius is seldom prescribed alone, but is most usually 
made the basis of diuretic mixtures, on the well-known prin- 
ciple of combination, which is here of essential service. 

R. Potassii acetatis 5.l' ss 5 or 61 Grm. 

Acetiscillse 15iv ; " 16 " 

Decocti scoparii [Br.] ad f§vj ; " 192| " M. 

Fiat mistura. Capiat unciam unam quartis horis. 



K. 



s. 



Tincturse digitalis 

Spiritus setlieris nitrosi, 

Spiritits juniperi, 

Succi scoparii [Br.] 

Aquae 

Ter die sumend. 


TTjx; 

aa f 5ss ; 
ad fgj ; 


or 

a 
(t 


2 

4 

32 



65 Gm. 



M. 



SENEGA—SENEKA. 

[ The root of Poh/ gal a Senega, U. S. 

Dose, in .substance, gr. xx (1.30 Gm.). 

Officinal Preparations, U. S. 

Deeoetum Senegae ( gj to Oj). Dose, f,gj (32. Gm.). 

Extractum Senegae (alcoholic). Dose, gr. j-iij (.06 
to .20 Gm.). 

Extractum Senegae Fluidum. Dose, n^x-xxx 
(.65 to 2. Gm.). 

Syrupus Senegae. Dose, f3j (4. Gm.). 

It also enters into Syrupus Scillse Compositus.] 

Local Effects. 
No external or local action has been described. 



388 



SENNA. 



Constitutional Actions. 



Physiological. 

The principal action of 
senega is that of stimulating 
the mucous membrane of the 
bronchial tubes, and possi- 
bly, by a tonic influence on 
their muscular tissues, facili- 
tating the expulsion of their 
contents. It has also been 
accredited with diaphoretic, 
diuretic, and emmenagogue 
properties, but is seldom em- 
ployed in any other capacity 
than as an expectorant. 



Therapeutical. 

Senega is of great service 
in the more chronic condi- 
tions of 'pneumonia and bron- 
chitis, where it seems to help 
the patient to get rid of the 
large quantities of secretion 
frequently accumulated 
within the lungs. Theoreti- 
cally at least, its stimulating 
properties would contra-indi- 
cate its use in the more acute 
pulmonary affections, but in 
the later stages of bronchitis, 
and more especially those 
cases occurring among the 
very old, or young, it is of real 
value. 



Dose and Mode of Administration. 

The infusion is the preparation most commonly employed, 
and it is generally combined with carbonate of ammonia and 
other expectorants. Thus : — 



R. Ammonii carbonatis gr. iv ; 

Tincturse scillae n\, xv '■> 

Tinct. camphor* comp. [Br.] Hixxv 
Extracti glycyrrhizae gr. v ; 

Infusi senegse [Br.] ad f§j ; 

Fiat haustus ter die sumendus. 



or 



1 
1 

32| 



25 Gm. 

60 " 
30 " 



M. 



SENNA— SENNA. 

[ The leaflets of Cassia acutifolia (Delile), of Cassia abovata (De Can- 
dolle), and of Cassia elongata (Lemaire, Journ. de Pharm., vii., 
345), U. S. 

Officinal Preparations, U. S. 

Confeetio Sennae. Dose, 3j-ij (4. to 8. Gm.). 
Extractum Sennae Fluidum. Dose, f3j-iv (4. to 
16. Gm.). 



VIRGINIA SNAKEROOT. 389 

Infusum Sennae (Jj to Oj). Dose, fjij-iv (64. to 
128. Gra.). 

Tinetura Rhei et Sennas. Dose, f^ss-ij (16. to 
64. Gm.). 

And enters into Syrupus Sarsaparillse Cornp.] 

Internal Effects. 
Physiological. Therapeutical. 

Senna irritates the small Senna is a most useful 
intestine, causing copious, purgative, ranking among the 
thin, yellow evacuations, and cathartics with slightly dras- 
stimulating the peristaltic tic tendencies, and it may be 
movements of the bowel. prescribed in simple consti- 

pation, in dyspepsia, and in 
a large variety of conditions 
where rapid and effectual 
unloading of the bowels is 
required. 

Dose and Mode of Administration. 

Senna is seldom prescribed alone, as it is then apt to 
cause irregular contraction of the intestines and griping. It 
is therefore usually combined either with other purgatives, 
as mag. sulph. [black draught], or with various aromatics, 
as in the confection and compound mixture. 

Cassia and tamarinds have both a slightly purgative 
action, but are only used as ingredients in various compound 
preparations, as the confection of senna. [The syrup of senna 
(not officinal) is a good purgative for young children, dose 

f'3J-"J-] 



SERPENTARIA— VIRGINIA SNAKEROOT. 

[ The root of Aristolochia Serpentaria, of Arislolochia reticulata, and of 
other species of Aristolochia, U. S. 

Officinal Preparations, U. S. 

Extractum Serpentaria^ Fluidum. Dose, gtt. xx 
(1.30 Gm.). 

Infusum Serpentaria^ (|ss to Oj). Dose, f^j-iv 
(32. to 128. Gm.). 

33* 



390 SUET — MUSTARD. 

Tinetura Serpentariae (gij to Oj). Dose, f3j-ij 

(4. to 8. Gm.).] 

This drug is probably a bitter tonic, but the other virtues 
with which it has been credited seem to rest on no very 
stable foundation. [It belongs to the class of the aromatic 
bitters, and is a good addition to other tonics, as cinchona, 
and is included in the composition of the popular Huxham's 
tincture — Tinetura Cinchona? Comp.] 



SEVUM— SUET. 

[ The prepared suet of Ovis Aries, U. S. 

Used only in pharmacy, and as an ingredient in Ceratum 
Resinae Compositum, Unguentum Hydrargyri, and Ung. 
Picis Liquidae. 

An ointment made by adding calomel gr. v-x to suet ^j is 
used with good effect in eczema capitis^] 

SINAPIS— MUSTARD. 

[Sinapis Alba. The seed of Slnapis alba, U. S. 
Sinapis Nigra. The seed of Sinapis nigra, U. S. 

Officinal Preparation, U. S. 
Charta Sinapis. Mustard papers (4 inches square).] 

Local Actions. 

Physiological. Therapeutical. 

Mustard applied to the Mustard is used, first, for 
skin causes a vivid redness, the relief of pain, and there 
with violent smarting and can be no doubt that benefit 
itching, and, if the applica- is thus derived in many ner- 
tion be continued too long, vous, rheumatic, and inflam- 
vesication may follow, and matory affections. In neural- 
even troublesome ulceration, gia, lumbago, sciatica, pleu- 
rodynia, pleurisy, pneumo- 
nia, peritonitis, colic, and a 
vast variety of painful dis- 
orders, we may expect to 
alleviate suffering in some 
measure by the use of sina- 
pisms, and at other times we 
use this mode of drawing 



MUSTARD. 391 

blood to the surface, and so 
relieving- the congestion of 
deeper parts, on the principle 
referred to under the heading 
of " Counter-irritation." 

Mustard poultices are most 
valuable in arousing patients 
from the dangerous comatose 
condition into which they 
occasionally drift in the 
course of some of the acute 
inflammations ; and sinapisms 
applied to the feet and calves 
are of service in the stupor of 
narcotic poisoning and in 
urcemic coma. 

Mustard baths may be 
employed to bring back the 
eruption of some abortive 
cases of the exanthemata, or 
as a stimulant in acute bron- 
chitis or in the convulsions 
of children. 

Constitutional Actions. 

Physiological. Therapeutical. 

Digestive Organs — Mus- Mustard is extensively 
tard increases the appetite by used as a dietetic condiment, 
irritating the mucous mem- 
brane of the stomach, but 
does not increase the secre- 
tion of gastric juice. 

It acts as a prompt and This emetic power is of 
effectual emetic of the direct great value in cases of poison- 
class, ing, as mustard is always at 

hand, and can be used at 
once. 

Mode of Administration. 

A mustard poultice must be made with cold water, for we 
know that hot water dissipates the volatile oil on which the 



392 sodium. 

counter-irritation depends, vinegar destroys it, and alcohol 
prevents its formation. It must be kept on from twenty 
minutes to half an hour, according to circumstances. 



SODIUM— SODIUM. 

[Sodii Aeetas. Acetate of Sodium. Dose, gr. xx-5ij 
(1.30 to 8. Gm.). 

Sodii Biearbonas Venalis. (Used in making Aqua 
Acidi Carbonici, and Sodii Biearbonas.) 

Sodii Boras (Borax). Dose, gr. x-xl (.65 to 2.60 Gm.). 
Mel Sodii Boratis (3j to fgj). 
Glyceritum Sodii Boratis (3ij to f^j). 

Sodii Carbonas. (In making Aluminii Sulphas, Anti- 
monii Oxysulphuretum, Bismuthi Subnitras, Cadmii Sul- 
phas, Bismuthi Subcarbonas, Calcii Carbonas Prascipitata, 
Ferri Subcarbonas, Liquor Sodce, Liquor Soda? Chlorinatas, 
Pilula Ferri Carbonatis, Piluloe Ferri Composite, Potassii 
et Sodii Tartras, Sodii Carbonas Exsiccata, Sodii Phosphis, 
and Zinci Carbonas Praecipitata.) 

Sodii Chloridum (table-salt). (For making Calomel 
and Corrosive Sublimate.) 

Sodii Hypophosphis. Dose, gr. x-xxx (.65 to 2. 
Gm.). 

Sodii Hyposulphis. Dose, gr. x-xx (.65 to 1.30 
Gm.). 

Sodii Nitras. (In making Sodii Arsenias.) 

Sodii Sulphas. Glauber's Salt. Dose, ^ss-j (16. to 
32. Gm.). (Also used in making Sodii Carbonas.) 

Sodii Sulphis. Dose, gr. xx-3j (1.30 to 4. Gm.). 

Officinal Preparations, U. S. 

Soda. Caustic Soda. 

Liquor Sodae. Dose, well diluted, n^v-x (.30 to .65 
Gm.). 
Sodii Arsenias. Dose, gr. T \-± (.005 to .02 Gm.). 
Liquor Sodii Arseniatis. Dose, nyij-v (.20 to .30 
Gm.). 



sodium. 393 

Sodae Biearbonas. Dose, gr. x-xx (.65 to 1.30 Gm.). 
Pulveres EfFervescentes. Soda powders. 
Pulveres EfFervescentes Aperientes. Seidlitz powders. 
Trochisci Sodii Bicarbonatis. 

Sodii Carbonas Exsiccata. (Used in making Sodii 
Arsenias.) 

Sodii Phosphas. Dose, as a cholagogue, gr. xx-xl, or 
as a purgative, 3J-ij (1.30 to 64. Gm.). (Used in making 
Ferri Phosphas and Ferri Pyrophosphas.) 

Liquor Sode Chlorinate. Labarraque's Solution. 
Dose, l5 ss ~j (2. to 4. Gm.), well diluted. 

Poisoning. 

Soda is a corrosive mineral poison, and its symptoms and 
morbid appearances are analogous to those following the use 
of potassa. 

Tests. 

Caustic soda in solution is not precipitated by bichloride of 
platinum, or tartaric acid ; its alkaline nature can be ascer- 
tained by the usual tests. Antimoniate of potassium affords 
a white precipitate when added to the salts of soda. Soda 
tinges the outer flame of the blowpipe yellow. 

Antidotes. 
The same as for potassa.] 

Effects and Uses. 

The soda salts have none of the depressing action on the 
heart which we have seen to be possessed by potash. 

Locally, we may use soda in acute eczema; or the hypo- 
sulphite in parasitic skin-disease, where it acts in virtue of 
the contained sulphurous acid ; and the biborate, or borax, 
as a gargle, as a lotion in pruritus and various skin diseases, 
and as an application to [aphthous] ulcerations about the 
mouth. 

A saturated solution of carbonate of soda is said to be a 
very soothing application in burns. [It must be applied 
cold, and, therefore, is not well adapted to cases where a 
large area is injured, for fear of chill and internal conges- 
tion.] 



394 SODA-MINT. 

Soda is not so much used internally as a remedy for gout 
and rheumatism, because the urate of soda is less soluble 
than the urate of potash ; but it is one of our best remedies 
in those forms of dyspepsia with pain after food, weight at 
the stomach, red fissured tongue, cough, and palpitation. 
The hyposulphite is useful in sarcinous vomiting. 

[The bicarbonate is a remedy of value in irritability of 
the bladder. It is also frequently used in combination with 
syrup of rhubarb in catarrhal jaundice.'j 

Sodium chloride is a good emetic ; the phosphate and tar- 
trate are purgative, but none of the preparations appear to 
be decidedly diuretic in their action. Sodium sulphate and 
phosphate have been found by Rutherford to increase the 
secretion of bile. 

Seidlitz Powder. Pulvis Effervescens Aperiens. 



R. Potassii et sodii tart. 


5ij; 


or 


8 


Gm. 


Sodii bicarbonatis 


gr. xl ; 


a 


2 


60 " 


Misce, ut fiat haustus effervescens 


cum 








Acidi tartaric! 


gr. xxxv ; 


a 


2 


30 " 


Aquae 


t$iv; 


it 


128 


ii 


Statim sumendus. 








R . Sodii bicarbonatis 


gr xx ; 


or 


1 


30 Gm. 


Tinct. calumbae 


ttixx ; 


i i 


1 


30 " 


Syrupi zingiberis 


f5ss; 


tt 


2 




Infusi gentianse compositi 


ad f §j ; 


u 


32 




Misce, ter die sumend. 











as 



Useful draught in dyspepsia. 

[The following is a pleasant antacid combination, known 

Soda-Mint. 



R. Sodii bicarbonatis, 

Sacchari, aa 5ij ; or 8 

Spiritus ammoniaa aromatici nixl ; 2 

Aquae menthae piperitae q. s. adf^viij ; li 256 

M. S. Dose, a tablespoonful after meals. 



Gm. 
60 " 



Used in flatulent dyspepsia. It admits of the addition .of 
tincture of mix vomica, or syrup of rhubarb,] 



PINKROOT — BAY-RUM. 395 

[SPIGELIA— PINKROOT. 

The root of Spigelia Marylandica, U. S. 
Dose, in substance, 5j (4. Gm.). 

Officinal Preparations. 

Extraetum Spigelian Fluidum. Dose, f5j-ij (4. 
to 8. Gm.). 

Extraetum Spigelian et Sennas Fluidum. Dose, 

f3ij-iv (8. to 16. Gm.). 

Infusum Spigelian (|ss to Oj). Dose, fgiv-viij ; for 
a child, f5\j-f§j (8. to 256. Gm.). 

Spigelia is an efficient remedy against the round worms, 
or lumbricoids, and in moderate doses, is entirely safe ; but 
in overdoses has narcotic properties. It is given in infusion 
or syrup, morning and evening, for two or three days, fol- 
lowed by a brisk cathartic. The chief objection to the use 
of spigelia is, that it imparts its red color to the clothing, 
and, if the baby vomits after taking a dose, it is likely to 
cause trouble.] 



[Spiritus. 

List of Spirits officinal in the U. S. P. : — 

Spiritus iEtheris Compositus Spiritus J.uniperi Compositus 

" Nitrosi '. " Lavandulae 

" Ammonise " " Compositus 

" Aromaticus " Limonis 

" Anisi " Menthse Piperitse 

" Campliorse " " Viridis 

" Chloroformi " Myrruae 

" Cirmamonii " Myristicse 

" Frumenti " Vini Grallici.] 
' ' Juniperi 



[SPIRITUS FRUMENTI— WHISKEY. 

Spirit obtained from fermented grain by distillation, and containing from 
48 to 56 per cent, by volume of absolute alcohol, U. S. 



SPIRITUS MYRCI^E— BAY-RUM. 

The spirit obtained by distilling rum with the leaves of Myrcia acris, 

{Schwartz'), U. S. 



396 BRANDY — STRAMONIUM. 



SPIRITUS VINI GALLICI— BRANDY. 

The spirit obtained from fermented grapes by distillation, and containing 
from 48 to 50 per cent, by volume, of absolute alcohol, U. S. 



For effects and uses, see Alcohol.] 



[STATICE— MARSH-ROSEMARY. 

The root of Statice Limonium Caroliniana, U. S. 

Statice is a powerful, indigenous astringent, and may be 
used as a substitute for kino and catechu. It has been quite 
popular as an application to ulceration of the throat. In 
scarlatina, it is used both as an internal and local remedy. 
The infusion or decoction is generally employed.] 



[STILLINGIA—STILLINGIA. 

Syn. Queen's Root. 
The root of Stillingia salvatica, U. S. 

Dose, in substance, gr. xx (1.30 Gm.). 

Officinal Preparation, U. S. 

Extractum Stillingiae Fluidum. Dose, n^xx-xl 
(1.30 to 2.60 Gm.). 

Stillingia is highly esteemed as an alterative in secondary 
syphilis, skin disease, ' and scrofula. In large doses it is 
emetic and cathartic. As an alterative, it is frequently given 
in combination with sarsaparilla. A decoction (3J to Oiij 
boiled to Oj), dose, f^j-ij (32. to 64. Gm.) ; and a tincture 
(,?ij t0 Qj), dose, f'3j (4. Gm.), are largely used in the South, 
but are not officinal.] 



STRAMONIUM— STRAMONIUM. 

[Stramonii Folium. The leaves of Datura stramo- 
nium, XT. S. 

Stramonii Semen. The seed of Datura stramonium, 
U. S. 



STORAX — SULPHUR. 39T 

Officinal Preparations, U. S. 

Extraetum Stramonii Foliorum. Dose, gr. |— £ 
(.015 to .03 Gm.). 

Extraetum Stramonii Seminis. Dose, the same. 

Tinetura Stramonii (seeds ^ijtoOj). Dose, n^x-xx 
(.65 to 1.30 Gm.). 

Unguentum Stramonii (extract, 5j to gj). 

Antidotes. 

The same as for belladonna-poisoning. See page 159.] 

After the careful description already given of the actions 
and uses of belladonna, it is unnecessary to say much about 
stramonium. Modern investigation has shown that the active 
principle, daturia, is identical with atropia ; and the only 
marked difference between the two plants seems to consist 
in the more decided antispasmodic properties of stramonium, 
which cause it to be much prized as a remedy for asthma. 
In the purely spasmodic varieties of that disease, and most 
efficiently when inhaled in the form of smoke, it seldom fails 
to give relief. 



[STYRAX— STORAX. 

A balsam prepared from the baric of Liquidambar orientate 
(Lamarck), U. S. 

Storax has been recommended as a substitute for copaiba 
in the treatment of gonorrhoea and gleet; and mixed with 
olive oil, equal parts, is effectual in the treatment of scabies. 
It is ranked as a stimulating expectorant, but is chiefly used 
as an ingredient in the compound tincture of benzoin.] 



[Sueci. 

The officinal Juices are — 

Succus Conii Succus Taraxaci.] 



SULPHUR— SULPHUR, 

[Sulphur Lotum. Sublimed sulphur, thoroughly 
washed with ivater, U. S. 

Sulphur Sublimatum. Sublimed sulphur, U. S. 
34 



398 SULPHUR. 



Officinal Preparations, U. S. 

Sulphur Prsecipitatum. Dose, 3j-uj (4. to 12. 
Gm.). 

Sulphuris lodidum. Not used internally. 

Unguentum Sulphuris (1 part sulphur, 2 parts 
lard). 

Unguentum Sulphuris Iodidi (gr. xxx to )§j). 

Sodii Hyposulphis. Dose, gr. xv (1. Gm.). 

Sodii Sulphis, ) Dose, gr. xx to 5j 

Potassii Sulphis. ) (1.30 to 4. Gm.). 

Sublimed sulphur is used in making Emplastrum Ammo- 
niaci cum Hydrargyro, Hydrargyri Sulphuretum Rubrum, 
Potassii Sulphuretum, Sulphur Praecipitatum, and Sulphuris 
lodidum.] 

External Use. 

Sulphur is used externally as a stimulant in various forms 
of chronic skin disease, such as acne faciei, and more espe- 
cially in itch, a disease dependent on the presence of a 
minute insect, the acarus scabiei, the male of which ranges 
freely over the skin, whilst the female retires with her eggs 
to oblique burrows in the cuticle. These receptacles having 
been broken up by soap and water, sulphur ointment is care- 
fully spread over all the patient's body at bed-time, and 
Avashed away by a warm bath next morning. Two or three 
applications of this sort are sufficient to cure the disease, and 
if the patient's skin will bear the unguentum sulphuris, one 
smearing with this may be sufficient. The rationale of the 
treatment is, not that sulphur acts as a direct poison to the 
acarus, but that it forms with lard a very tenacious and adhe- 
sive substance which suffocates the insect by blocking up its 
air-pores. [The sulphur ointment should generally be 
diluted j; to |, as it is apt to produce too great irritation.] 

Sulphur is also in great favor as a popular remedy for 
rheumatism, sprinkled on new flannel and applied to the 
painful part, and there is no doubt that some beneficial 
action may thus be caused. Lastly, sulphur makes a useful 
bath in some forms of chronic skin disease. 



SULPHUR. 



399 



Internal Use. 
Physiological Action. Therapeutical Action. 



1. It has been supposed to 
exert a stimulating influence 
on the mucous membranes 
and skin. 



2. It causes slight increase 
of the peristaltic movements 
of the bowels. 



3. Sulphur has well-marked 
antiseptic properties in con- 
sequence of its destructive 
power over the lower forms 
of vegetable life. 



1. In virtue of this, it 
used to be occasionally pre- 
scribed in chronic bronchitis 
and phthisis, and also used 
externally in shin diseases. 
To its action on the skin may 
be attributed its undoubted 
power of aiding, — more es- 
pecially in the form of bath, 
— the elimination of lead and 
mercury from the system. 
Sulphur has lately been re- 
commended as the best means 
of preventing mercurial sali- 
vation. 

2. It acts, therefore, as a 
gentle laxative, slightly soft- 
ening the feces, and from 
the mildness of its action it 
is specially useful in piles 
and all irritable conditions 
about the rectum. Its pur- 
gative action is increased by 
its being dissolved and formed 
into a sulphide by the alkali 
of the bile. 

3. Burnt in a room with 
closed doors and windows, it 
is the best way to remove the 
germs of infection from the 
air by fumigation. 



Sulphur is given off from the system principally by the 
bowels, but also by the milk, the sweat, and the skin, in 
the form of sulphuretted hydrogen, and by the urine as a 
sulphate. 

Strong applications of sulphur frequently irritate the skin, 
and bring on troublesome eczema. The disadvantage of sul- 



400 



TOBACCO. 



phur as an aperient, is the offensive odor which the sulphur- 
etted hydrogen communicates to the feces. 

The confection [Br.] is the best purgative form [containing 
sulphur §iv, and cream of tartar ^j, in syrup of orange-peel 
f 3iv], in tea- or tablespoonful doses, and for external use the 
ointment is generally prescribed. 

[The sulphites have been recommended by Polli in drachm 
doses for pyemia and septicemia, but more extended experi- 
ence declares them to be worthless for this condition. The 
sulphite or the hyposulphite of soda is sometimes given in 
yeasty or sarcinous vomiting to prevent fermentation.] 



[Suppositoria. 

The officinal Suppositories are — 



Suppositoria Acidi Carbolici 
" " Tannici 

Aloes 
" Assafoetidre 

" Belladonnse 



Suppositoria Morpliise 
" Opii 

" Plumbi 

" Plumbi et Opii.] 



[Syrupi. 



The officinal Syrups are- 

Syrupus Acacise 

" Acidi Citrici 

Allii 
" Amygdalae 
" Aurantii Corticis 
" " Florum 

" Eerri Iodidi 
" Fuscns 
' ' Ipecacuanha} 
'" Kramerise 
' ' Lactucarii 
" Li mon is 



Syrupus Pruni Virginians 

" Rhei 

" " Aromaticus 

" Rosa? Gallicse 

" Rubi 

" Sarsaparillse Comp. 

" Scillse 

" " Compositus 

" Senega) 

" Tolutanus 

" Zingiberis.] 



TABACUM— TOBACCO. 

[ The commercial dried leaves of Nicotiana Tabacum, U. S* 
Officinal Preparations, U. S. 

Infusum Ta"baci (5j to Oj). Dose, f5ij (8. Gm.). 
Oleum Tabaei. Not used internally. 
Unguentum Tabaei. (Watery extract of leaves 3J 
to Sxvj of lard.) 

Vinum Tabaei. Dose, gtt. xx (1.30 Gm.). 



TOBACCO. 



401 



Antidotes. 

Strychnia, and diffusible stimulants may be regarded as 
physiological antidotes to tobacco ; and, after thoroughly 
washing out the stomach, tincture of digitalis may be ex- 
hibited to counteract the depressing influence of the poison 
on the heart, and the tendency to collapse. Respiration 
should be stimulated by ammonia, frictions, and even main- 
tained artificially. Sulphate of strychnia may be given 
hypodermically, and stimulating enemata injected.] 

Effects and Uses. 

Tobacco is now rarely, if ever, used internally in medi- 
cine, on account of its poisonous properties ; but it is a sub- 
stance in such general domestic use, and therefore of so 
great physiological interest, that we must devote some little 
space to considering the results of modern experiment on its 
action. 



Local Action. 



Physiological. 

Tobacco is readily absorbed 
by the skin, and symptoms 
of poisoning have followed 
the application of strong infu- 
sions to the unbroken cuticle. 



Therapeutical. 

Tobacco has been used as 
a local application in prurigo 
and other skin diseases, but 
is too readily absorbed to de- 
serve recommendation for this 
purpose. 



Internal Actions. 



1. Brain and Nervous Sys- 
tem. — The brain seems to be 
little affected, but some ex- 
citement of the spine is an 
early symptom of the poison- 
ous action of the drug, speedily 
followed, however, by mus- 
cular relaxation and paralysis, 
also of spinal origin. 

The sensory nerves are not 
affected, but we find lowering 
of the functional activity of 

34 



1. Before the introduction 
of chloroform, advantage was 
taken of the depressing and 
relaxing influence of tobacco 
on the muscular system to 
employ the enema in stran- 
gulated hernia and disloca- 
tions. Any occasional suc- 
cess, however, was amply 
counterbalanced by the in- 
conveniences and even dan- 
gers which too often resulted ; 



402 



TOBACCO. 



the motor nerves. The pupil 
is contracted. 



• 2. Circulation and JRcspi- 

ration It is not necessary 

for us to go into the elaborate 
and contradictory series of 
experiments made to prove 
the fact that tobacco is a 
powerful depressant of the 
heart's action. The temper- 
ature usually falls in tobacco- 
poisoning, and death ensues 
from respiratory paralysis. 
[Excessive use of tobacco 
produces functional disor- 
der of the heart, which may 
result in hypertrophy, dila- 
tation, and organic disease.] 
3. Digestive and Secreting 

Organs Tobacco usually 

causes nausea and vomiting, 
as most smokers can testify ; 
but toleration is soon estab- 
lished, and even considerable 
doses then fail to disturb the 
equanimity of the digestive 



and this application of the 
drug has now fallen into well- 
merited oblivion. 

In consequence of its low- 
ering action on the reflex 
function of the spinal cord, 
it has been proposed as a 
remedy for tetanus and an 
antidote for strychnia, and 
the alkaloid nicotia will be 
found most convenient for 
these purposes. 

The use of tobacco is be- 
lieved to have some injurious 
effect on vision ; and Hutch- 
inson and others have re- 
corded instances of atrophy 
of the optic nerve and total 
blindness thus produced. 

2. Tobacco-smoking has 
been known to give relief 
in asthma and chronic bron- 
chitis. 



3. [The post-prandial cigar 
is thought to aid digestion 
by confirmed smokers, and, 
in some cases, increases either 
the peristalsis or secretions of 
the intestine, or both, thus 
acting as a laxative.] 



TAMARIND — DANDELION. 403 



organs, save a slightly pur- 
gative action on the bowels. 
It is stated, however, that 
in . habitual smokers some 
symptoms of dyspepsia may 
be detected, indicated by 
furred tongue and loss of 
appetite ; and there is also 
some generally-diffused, gran- 
ular irritation about the pha- 
rynx. 



[TAMARINDUS— TAMARIND. 

The preserved fruit of Tamarindus Indica, U. S. 

Tamarinds are laxative, and are used in making a re- 
frigerant drink for the sick. They enter into the Confectio 
Sennas.] 



[TAPIOCA—TAPIOCA. 

The fecula of the root of Janipha Manihot (Bot. Mag. 3071), U. S. 

Tapioca, the starch of the Cassava plant, is used like 
arrowroot as an article of diet.] 



TARAXACUM— DANDELION. 

[ The root, gathered in the autumn, of Taraxacum Dens-leonis 
(De Candolle), U. S. 

Officinal Preparations, U. S. 

Extractum Taraxaei. Dose, 2:1*. xx-xxx (1.30 to 
2. Gm.). 

Extractum Taraxaei Fluidum. Dose, f5j-ij 
(4. to 8. Gm.). 

Infusum Taraxaei (^ij to Oj). Dose, f^iv (128. 
Gm.). 

Sueeus Taraxaei. Dose, f3ij-iv (8. to 16. Gm.).] 

Taraxacum is usually prescribed as a matter of routine in 
sluggish liver, and the various forms of dyspepsia depending 
on a supposed deficiency of bile ; but although it may have 
some mild tonic, diuretic, and aperient properties, there is 



404 TURPENTINE. 



/ 



not the slightest evidence for asserting that it exerts any 
real influence over the hepatic functions. 

I£. Succi taraxaci f 5J '■> 0Y 

Acidi nitro-muriatici dil. TT^x ; " 

Tincturse lupulinse tt\, xx 5 " 

Aqua* ad f §j ; " 32j M. 

S. Ter die suineiid 



4 


Gm. 




65 " 


1 


30 " 


32 


<< 



TEREBINTHINA— TURPENTINE. 

[The concrete oleo-resin obtained from Pinas palustris, and from other- 
species of Pinus, U. S. 

TEREBINTHINA CANADENSIS— CANADA 
TURPENTINE. 

The liquid oleo-resin obtained from Abies balsamea (Lindlei/, Flor. 

Med.), U. S. 

Enters into Ceratum Resinas Compositum, Emplastrum 
Galbani Compositum (of Turpentine) ; and Charta Can- 
tharidis and Collodium Flexile (of Canada Turpentine). 

OLEUM TEREBINTHINJ5—OIL OF 
TURPENTINE. 

The volatile oil distilled from the turpentine of Pinus palustris and of 
other species of Pinus, U. S. 

Dose of oil of turpentine ttt,x-xx (.65 to 1.30 Gm.), given 
3 or 4 times daily, in typhoid fever, or chronic dysentery ; 
or f'3J to f^ss (4. to 16. Gm.) as a vermifuge. 

Officinal Preparation, U. S. 

Linimentum Terebinthinse. Used as a counter- 
irritant. 

Turpentine enters into Linimentum Cantharidis.] 

Local Action. 

Physiological. Therapeutical. 

Turpentine, when applied This effect of turpentine 
to the skin, causes redness, causes it to be much used as 
tingling, and irritation, lead- a counter-irritant in those 



TURPENTINE. 



405 



ins on to acute inflammation 
and blistering, if not removed 
within a limited period. 



cases where we wish to re- 
lieve congestion of internal 
organs by driving the blood 
to the surface. Thus, in 
peritonitis, pneumonia, bron- 
chitis, and asthma, it is fre- 
quently employed, either 
sprinkled on hot flannel, or 
in the form of the linimentum 
terebinthinaa of the Pharma- 
copoeia. 



Constitutional Actions. 



Physiological. 

1. On the Brain Tur- 
pentine produces, in large 
doses, giddiness, and other 
symptoms somewhat resem- 
bling alcoholic intoxication, 
and even ending in coma in 
rare instances. 

2. Circulation — Turpen- 
tine acts at first as a stimulant 
to the heart, and has un- 
doubted astringent proper- 
ties, partly, no doubt, from 
its coagulating influence on 
the albumen of the tissues, 
but also by causing contrac- 
tion of the smaller vessels. 



3. Digestive and Secreting 
Organs Turpentine is dis- 
tinctly irritating to the ali- 
mentary canal, frequently 
causing vomiting and diar- 
rhoea, and it has the property 
of checking mucous secre- 
tions from the various canals. 

It is also a very certain 
diuretic of the stimulating 
class, but must be used with 



Therapeutical. 



2. As an astringent, tur- 
pentine is valuable in various 
forms of hemorrhage, but 
more especially in that from 
the kidney and in purpura 
hemorrhagica [but is now 
rarely used as a haemostatic, 
oil of erigeron Canadense, 
ergot, and the mineral astrin- 
gents being more reliable, 
and less irritating]. 

3. Turpentine is a valua- 
ble astringent in some forms 
of diarrhoea, and more espe- 
cially that which results from 
the later and ulcerative stage 
of enteric or typhoid fever. 
It is highly recommended in 
the same disease by some 
authorities when abdominal 
pain and distension coincide 
with a raw, clean, dry tongue, 



406 



TURPENTINE. 



caution, as it is apt to cause 
frequent and painful mictu- 
rition with bloody urine, and 
eventual suppression of the 
secretion [strangury], and 
acute inflammation of the 
kidneys. 



and in ordinary tympanites 
it makes a good addition to a 
purgative enema. It has been 
recommended by Dr. King 
Chambers as an enema in 
sciatica, where it is supposed 
to act locally on the affected 
nerve, which, at one part of 
its course, lies directly in 
contact with the large intes- 
tine ; and it has long enjoyed 
a well-deserved reputation as 
an anthelmintic in cases of 
tape-worm. 

Turpentine has also been 
given in small doses to check 
the excessive secretion in 
some forms of bronchitis, 
and it may also be of service 
in chronic cystitis, gleet, and 
pyelitis. 

It has also been used in 
iritis with alleged success, 
though it is difficult to see 
on what principle. 

Mode of Elimination. 

Turpentine is rapidly absorbed into the blood, and as 
quickly passes out, principally by the lungs and kidneys, im- 
parting to the urine a peculiar violet odor. 

[Old oil of turpentine is considered an efficient antidote 
against phosphorus-poisoning.] 



Dose and Mode of Administration. 



I£. Olei terebintliiiiae f 5j ; 

Mucilaginis acaciae f3 y J 

Misturae amygdalae, 

Aquae laurocerasi [Br.], aa f^ss ; 
S. f 5j pro dosi quartis horis. 



or 



4 
20 

16 



Gm. 



M. 



A few drops may be given on a lump of sugar, in hemor- 
rhage. 

As an anthelmintic, half an ounce may be prescribed [com- 
bined with an ounce of castor oil, and is very effective against 
round worms as well as tcenice~\. 



OYSTER-SHELL. 



407 



[TESTA— OYSTER-SHELL. 

The shell of Ostrea edulis, U. S. 

Officinal Preparation, U. S. 

Testa Prseparata. Dose, gr. x-xl (.(55 to 2.60 Gm.).] 

Prepared oyster-shell, eonsisting of 98 per cent, of car- 
bonate of calcium, is used in impalpable powder as an. antacid 
in dyspepsia. Castillon's powders consisted of sago, salep, 
tragacanth, each in powder, aa 5J> prepared oyster-shell 9j, 
and some cochineal as a coloring ingredient. A decoction 
of this powder in milk (3j to Oij) may be used freely as an 
article of diet in bowel-affections. 



[Tincture, 

The officinal Tinctures are — 



Tinctura Aconiti Radicis 

" Aloes 

" " et Myrrhae . 

Arnicae 

" Assafcetidae 

" Aurantii 

" Belladonnas 

' ' Benzoini 

' ' Composita 

" Calumbse 

" Cannabis 

" Cantharidis 

" Capsici 

Cardaraomi 

" " Composita 

" Castorei 

" Catechu 

" Cinchonas ♦ 

" " Composita 

' ' Cinnamomi 

' ' Colchici 

' ' Conii 

1 ' Cubebse 

" Digitalis 

" Ferri Chloridi 

" Gallse 

" Gentianae Composita 

" Guaiaci 

" " Ammoniata 



Tinctura Hellebori 

" Humuli 

' ' Hyoscyami 

1 ' Iodinii 
" " Composita 

" Jalapae 

" Kino 

" Krameriae 

" Lobelias 

" Lupulinae 

' ' Myrrhae 

" Nucis Vomicae 

" Opii 
" " Acetata 

" tl Camphorata 

" " Deodorata 

" Quassiae 

" Rhei 
" " . et Sennae 

" Sanguinariae 

" Scillae 

' ' Serpentariae 

" Stramonii 

" Tolutana 

" Valerianae 
" , " Ammoniata 

' ' Veratri Viridis 

u Zingiberis.] 



408 TRAGACANTH — SLIPPERY-ELM. 



TRAGACANTHA—TRAGACANTH. 

[A gummy exudation from Astragalus verus {Olivier'), and from other 
species of Astragalus, U. S. 

Officinal Preparations, U. S. 

Mueilago Tragaeanthae, as a vehicle. _ 

Trochisci Acidi Tannici, Trochisci Ipecacuanhas, Tro- 
chisci Potassii Chloratis, Trochisci Santonini, and Trochisci 
Zingiberis.] 

Tragacanth is of service as a vehicle for the suspension 
and division of various powdered drugs. 



[Trochisci. 

The officinal Lozenges are — 

Trochisci Acidi Tannici Trochisci Menthse Piperitae 

" Cretse " Morph. et Ipeoacuanhse 

" Cubebae " Potassii Chloratis 

" Ferri Suhcarhonatis " Santonini 

" Grlycyrrbizae et Opii " Sodii Bicarhonatis 

" Ipecacuanhas " Zingiberis.] 

' ' Magnesias 



ULMUS— SLIPPERY-ELM. 

[The inner bark of Ulmusfulva (Michaux), U. S* 

Officinal Preparation, U. S. 

Mueilago Ulmi. Used externally.] 

Elm bark is probably tonic and astringent, but is rarely if 
ever used [except as an emollient application in external 
inflammations, such as erysipelas]. 



RAISINS — BEAR BERRY. 



409 



if 



[Unguenia. 

The officinal Ointments are — 

Unguentum (Unguentum Adipis, Unguentum 
U.S. P. Ed. 1860.) - 
" Acidi Carbolic! 

Acidi Tannici 

Antimonii 

Aquse Rosse 

Belladonnse 

Benzoini 

Cantliaridis 

Creasoti 

Gallse 

Hydrargyri 

" Ammoniati 

' ' Iodidi Rubri 

" Nitratis 



Hydrarg. OxidiFlavi 
" Rubri 
Iodinii 

•' Composituni 
Mezerei 
Piois Liquidae 
Plunibi Carbonatis 

Iodidi 
Potassii Iodidi 
Stramonii 
Sulphuris 

Iodidi 
Tabaci 
Veratrise 
Zinci Oxidi.] 



[UVA PASSA— RAISINS. 

The dried fruit of Vitis Yinifera, U. S. 

Raisins are laxative, and are used as a flavoring to demul- 
cent beverages. They enter into the Tincture of Rhubarb 
and Senna.] 



UVA URSI— BEARBERRY. 

[The leaves of Arctostaphylos Uva Ursi (Sprengel, Syst. II. 287), U. S. 

Officinal Preparations, U. S. 

Decoetum Uvse Ursi (§j to Oj). Dose, fgiv (128. 
Gm.). 

Extraetum Uvse Ursi Fluidum. Dose, f3j (4. 
Gm.).] 

Uva ursi is astringent and The astringency of this 

possibly diuretic. [It is also drug being principally di- 
tonic and antilithic, and is rected to the genito-urinary 
believed to favor uterine con- mucous membrane, it is held 
traction.] by surgeons to be of some 

service in various chronic 
aifections of these parts. 
35 



410 



VALERIAN. 



VALERIANA— VALERIAN. 

\_The root of Valeriana officinalis, U. S. 
Dose, in substance, gr. xxx to xc (2. to 6. Gm.). 

Officinal Preparations, U. S. 

Extractum Valerianae. Dose, gr. x-xxx (.(*> to 2. 
Gm.). 

Extractum Valerianae Pluidum. Dose, f 3j (4. 
Gm.). 

Infusum Valerianae (f^ss to Oj). Dose, f^ij-iv 
(64. to 128. Gm.). 

Oleum Valerianae. Dose, gtt-. iv-v (.25 to .30 Gm.). 

Tinctura Valerianae (^ij to Oj). Dose, f3i-ij (4. to 
8. Gm.). 

Tinctura Valerianae Ammoniata (^ij to Oj). 
Dose, f5j-ij (4. to 8. Gm.j.] 

Effects and Uses. 



Various elaborate investi- 
gations have been made in 
Germany on the physiologi- 
cal actions of valerian, but 
they have not much bearing 
on its practical application, 
and the drug itself is hardly 
of sufficient importance to 
justify us in devoting much 
time to its consideration. 
We may therefore say, gene- 
rally, that acceleration of the 
action of the heart, mental 
hallucinations, giddiness, and 
some digestive derangement 
are among the principal of 
the symptoms (described most 
fully by Phillips). 



The more important thera- 
peutic applications of valerian 
have not stood the test of 
time and experience, and its 
use is now practically re- 
stricted to hysteria and the 
various nervous conditions 
depending thereon. [In 
nervous headache, the am- 
moniated tincture is a reliable 
resource.] 

The oil is supposed to be 
the active principle. It may 
be used with ether for inhala- 
tion, in nervous headache. 



[Valerianic Acid. (See page 104.) 

Ammonii Valerianas. ) ^ . .. • A ~ , 10 

~ . . , T , f Dose gr. i-n (.Ob to .12 

Quiniae Valerianas. r' P 1 

Zinei Valerianas. ) m "'" 



AMERICAN HELLEBORE. 411 

The salts of valerianic acid are now generally used in the 
place of the preparations of valerian itself. These salts may 
be given in pill or in combination with simple elixir. The 
elixir of valerianate of ammonia is generally kept in the 
shops.] 



[VANILLA— VANILLA. 

The prepared unripe fruit of Vanilla aromatica, U.S. 

Used as a flavoring ingredient in Trochisci Ferri Sub- 
carbonatis, and Trochisci Potassii Chloratis.] 



VERATRUM ALBUM—WHITE HELLEBORE. 

[ The rhizome of Veratrum album, U. S.~] 

White hellebore possesses some of the physiological pro- 
perties of veratrum viride, but much of its energy is ex- 
pended on the alimentary canal, and violent vomiting and 
purging often follow its use. It is, therefore, now quite dis- 
carded from medical practice. When applied to the nostrils, 
even greatly diluted, it causes intense sneezing. 

Two alkaloids [in addition to veratria] have been dis- 
covered in the root-stalk, one of which has been called jervia, 
and the other veratralbia. 

[For the discussion of the effects of Veratria see Saba- 
dilla, page 375.] 



VERATRUM VIRIDE— AMERICAN HELLEBORE. 

[ The rhizome of Veratrum viride, U. S. 

Officinal Preparations, U. S. 

Extraetum Veratri Viridis Fluidum. Dose, 
gtt. j-iij (.06 to .20 Gin.). 

Tinctura Veratri Viridis (^viij to Oj). Dose, gtt. 
iij_viij (.20 to .50 Gm.). 

(Dr. Norwood's tincture is of the same strength as the 
officinal tincture.)] 

Some local action has been observed, of an irritant nature, 
somewhat resembling that of veratria. 



412 



AMERICAN HELLEBORE. 



Constitutional Actions. 



Physiological. 

1. Brain and Nervous 
System 1. Green helle- 
bore has no action on the 
brain. 

2. Spinal Cord A very 

decidedly depressing effect 
is exerted on the spine, indi- 
cated by extreme muscular 
prostration. 

II. Heart and Circula- 
tion Veratrum viride is 

also a powerful vascular de- 
pressant, the pulse rate being 
lowered, and the arterial ten- 
sion diminished ; these effects 
being due both to a direct 
action of the drug on the 
heart muscle and to stimu- 
lation of the cardiac inhibi- 
tory nerves. 



Therapeutical. 



III. No effect is produced 
on the respiration, but a dis- 
tinct lowering of temperature 
has been observed. 

IY. Digestive and Secret- 
ing Organs Veratrum vi- 
ride has emetic properties, 
and frequently causes vomit- 
ing ; and purging, also, not 
unfrequently follows its use. 



2. [It has recently been 
very highly recommended in 
puerperal eclampsia.^ 



II. Veratrum viride has 
been extensively used in 
America on account of its 
depressing influence on the 
circulation, and it is stated 
that we may get good results 
by prescribing it in the early 
stages of pneumonia and 
other inflammatory condi- 
tions. Little or no English 
experience, however, has yet 
been brought to bear on the 
discussion of this question. 
[The late Prof. Dickson 
prized it very highly in ty- 
phoid fever, administered in 
large doses, even as much as 
forty drops being given, with 
the best effects.] 



[IV. The nauseating and 
depressing effects are best 
counteracted by opium and 
alcoholic stimulants.] 



zinc. 413 

Two alkaloids exist in veratrum viride, Jervia and 
Veratroida, the main difference between which seems to 
be, that the latter is apparently responsible for the digestive 
disturbance which occasionally results. 



[Vina. 

The officinal Wines are — 

Vinum Aloes Vinum Opii 
" Antimonii " Portense 

u Colcliici Radicis " Rliei 

" " Seminis " Tabaci 

" Ergotse " Xericum.] 

" Ipecacuanha 



ZINCUM— ZINC. 

[Officinal Preparations, U. S. 

Zinei Oxidum. Dose, gr. ij-viij (.12 to .50 Gm.). 
Zinei Oxidum Venale. 

Unguentum Zinei Oxidi (1 to 5). 
Zinei Chloridum. As a caustic and astringent. 

Liquor Zinei Chloridi. (Burnett's Disinfecting Fluid.) 
Zinei Aeetas. 
Zinei Carbonas Prseipitata. 

Ceratum Zinei Carbonatis (1 to 5). 
Zinei Sulphas (white vitriol). Dose, as an emetic, 
gr. x-xxx (.65 to 2. Gm.). 

Zinei Valerianas. Dose, gr. i-ij (.06 to .12 Gm.). 

Antidotes. 

The alkalies and alkaline carbonates are the chemical 
antidotes to the salts of zinc. Evacuation of the stomach 
and bowels should be followed by the exhibition of eggs and 
milk. The retching, colicky pains, and diarrhoea, may be 
relieved by morphia hypodermically.] 

Local Actions. 
Physiological. Therapeutical. 

Chloride of Zinc is an Chloride of Zinc has 
exceedingly powerful caustic, been used as a caustic for 
and, in weak solution, has as- the treatment of cancerous 

35* 



414 



ZINC. 



tringent properties. The sul- 
phate and oxide are also as- 
tringent in varying propor- 
tions. 



and other ulcerations, either 
in strong solution, substance, 
or arrow-shaped masses made 
with flour, and inserted into 
incisions around the base of 
the morbid mass. It has 
turned out to be the principal 
ingredient in all so-called 
cancer curers' nostrums, and 
is employed in legitimate 
surgery as an application to 
wounds from which cancer- 
ous groivths have been re- 
moved, and also (in the 
strength of gr. lx ad f^j) 
to the raw surface after ordi- 
nary operations, with the 
view of preventing pyaemia. 
Sulphate of Zinc is a 
much-valued astringent lo- 
tion in conjunctivitis, and 
makes an excellent injection 
in gonorrhoea and leucor- 
rhcea ; and the oxide, either 
in powder or ointment, is 
one of the most useful appli- 
cations in chronic skin dis- 
ease. [The acetate is used 
for the same purposes as the 
sulphate (gr. ^ to ^ in rose- 
water 3j).J 



Internal Actions and Uses. 



Physiological. 

1. Action on Nervous Sys- 
tem. — This is probably tonic 
in character, and some as- 
tringent properties may also 
be noted. 



Therapeutical. 

1. We can thus explain 
the benefit which sometimes 
results from, the use of sul- 
phate of zinc in chorea. 
We here begin with a grain 
and continue in gradually 
increasing doses up to 6 or 
8 grains, tolerance being 



GINGER. 



415 



2. On Digestive System. 
. — Sulphate of zinc promptly 
and effectually empties the 
stomach, without causing 
much depression or nausea. 



rapidly established, and the 
emetic action of the drug 
avoided. Oxide of zinc, in 
doses of from 1 to 5 grains, 
is an excellent remedy in the 
night-sweats of phthisis, and 
it is also a valuable aid to 
treatment in the diarrhoea of 
children. 

2. It is therefore our most 
reliable direct emetic, invalu- 
able in cases of poisoning, in 
doses of from 20 to 30 grains. 



]$.. Zinci sulphatis gr. xxx ; or 
Aquae f §iij ; " 
Fiat liaustus emeticus statim sumendum. 


2 
256 


Gm. 
a 


M. 


I£. Zinci chloridi gr. j ; 


or 




06 Gm. 




Aquae rosae f §iv ; 


( ( 


128 


< ( 


M. 


A good injection in gonorrhoea. 










I£. Zinci oxidi 5ij '■> 


or 


8 


Gm. 




Glycerin se f 3ij 1 
Liquor plumbi subacetatis f 5iss ; 
Aquae calcis ad f§vj. 
Fiat lotio. 


a 
a 


8 

6 

192 


a 
a 
u 


M. 


Useful in impetigo. 










I£. Zinci valerianate gr. xxiv ; 


or 


1 


50 Gm. 




Confectionis rosae q. s. 










Fiat massa in pilulas duodecim dividenda. 


Deaui 


•entur 


pilulae. 










Nervine tonic. 











ZINGIBER— GINGER. 

[The rhizome of Zingiber officinale (Roscoe, Trans. Linn. Soc"), U. S. 
Dose, in substance, gr. x-xv (.65 to 1. Gm.). 

Officinal Preparations, U. S. 

Extraetum Zingiberis Fluidum. Dose, n^x-xx 
(.65 to 1.30 Gm.). 

Infusum Zingiberis (£ss to Oj). Dose, f ^ij-iv (64. 
to 128. Gm.). 



416 GINGER. 

Oleo-resina Zingiberis. Dose, n^ss-ij (.03 to .12 
Gin.). 

Syrupus Zingiberis. As a vehicle. 

Tinetura Zingiberis (giv to Oj). Dose, f 5 ss -j (2. 
to 4. Gm.). 

Troehisei Zingiberis (each containing n^ij of the 
tincture). 

Also enters into Acidum Sulphuricum Aromaticum, Piluloe 
Scillae Composite, Pulvis Aromaticus, Pulvis Rhei Com- 
positus, and Vinum Aloes.] 

Ginger is an agreeable stimulant and carminative. 



Having now completed the study of the various articles 
contained in the national Pharmacopoeia, we shall proceed 
to give a brief resume of the properties of the most useful 
among those drugs which have not yet received full official 
sanction. Among these will be found some very important 
remedies, also plants of great physiological interest, whose 
active medicinal powers have not yet been fully tested in 
practical medicine, and whose investigation opens up a valu- 
able field for clinical observation. 



REMEDIES IN FREQUENT USE, BUT NOT 
INCLUDED IN THE PRIMARY LIST OF THE 
MATERIA MEDICA, U. S. P. 



AMYL NITRIS. 

[Dose by inhalation, gtt. iij-v (.20 to .30 Gm.).] 

Local Action. 

Nitrite of amyl is not possessed of any local irritant or 
sedative properties. 

Internal Actions. 



Physiological. 

I. Nervous System 1. 

On Brain No special effect 

is produced on this organ 
beyond that resulting from 
dilatation of the cerebral 
vessels, and consisting of a 
sensation of fulness and op- 
pression in the head. Oph- 
thalmoscopic examination has 
proved the retina to be deep- 
ly congested during the in- 
halation of nitrite of amyl. 
Epileptics are observed to be 
unusually susceptible to its 
action. 



Therapeutical. 

I — 1. It has been recom- 
mended as a remedy for epi- 
lepsy, in virtue of its dilating 
powers releasing the vessels 
of the brain from that condi- 
tion of partial spasm which 
is said to be the cause of the 
disease. When given during 
the fit, it fails ; but in the 
hands of Crichton Browne, 
confirmed by Weir Mitchell 
and others, it has been suc- 
cessful when given before the 
paroxysm, when a distinct 
aura is felt and pallor of the 
face observed. It is also of 
great service in that perilous 
condition known as the status 
epilepticus. 



418 



AMYL NITRIS. 



2. On Spinal Cord A 

distinct lowering of reflex ir- 
ritability has been observed. 



II. Vascular System 1. 

On Heart. — After a brief in- 
halation of this drug, the 
action of the heart becomes 
excessively rapid, the face 
flushes, and a violent throb- 
bing in all the arteries is ex- 
perienced, with well-marked 
giddiness ; and if its admin- 
istration is pushed up to 
poisonous limits, there is 
much weakening of the car- 
diac pulsations. 

2. The effect on the arte- 
rial system is one of marked 
dilatation, the vessels enlarg- 
ing, as proved not only by 
general flushing, but by con- 
gestion of the retina, and by 
the free flow of blood from 
cupped surfaces which had 
previously yielded only a few 
drops. The arterial tension 
becomes much lowered, and 
this enlargement of the cali- 
bre of the vessels has been 
proved to depend on a direct 
action of the drug on the mus- 
cular coats of the arteries, 
and not on any intervention 
of the vaso-motor system. 

It has also been proved 
that oxidation is diminished, 
that the haemoglobin of the 
blood is checked in its func- 
tion of absorbing and cnving 
up oxygen, and that, previous 



2. It has been theoreti- 
cally recommended in cases 
of tetanus and strychnia-poi- 
soning, and in neuralgia its 
inhalation has apparently 
been followed by relief. 

II — 1. The nitrite of amyl 
has been proposed as an an- 
tidote in chloroform-poison- 
ing, and as a remedy for the 
peculiar heats and flushes 
met with in women about the 
menopause. 



2. In consequence of this 
dilating effect on the vessels, 
amyl has been most success- 
fully used in angina, pectoris. 
The essential condition here 
is supposed to be one . of 
spasmodic contraction of the 
smaller pulmonary and sys- 
temic vessels, against which 
the heart, generally weaken- 
ed, as it is in this disease, by 
mal-nutrition of its mucular 
structures, finds itself unable 
to cope, and hence the agoniz- 
ing distress. Inhalation of 
the drug releases the spasm, 
and so gives ease ; and this 
result follows whether there 
be actual valvular disease or 
not. 

This explanation of Brun- 
tius, who had the merit of 
first using the drug, has been 
disputed of late, Dr. George 



AMYL NITRIS. 



419 



to death, the color of the arte- 
rial and venous blood becomes 
almost precisely alike. 



III. On Respiration and 
Temperature. — During the 
early stage of amyl inhalation 
the respiration is hurried, but 
when the administration is 
further pushed the breathing 
becomes slower, and finally 
extinguished, from the arrest 
of the corpuscular action 
noted above, and from a para- 
lyzing effect on the respira- 
tory nervous centre. The 
temperature tends to fall, 
from the diminution in the 
process of oxidation. 

IV. On the Digestive Sys- 
tem The presence of sugar 

in the urine has been ob- 
served during amyl inhala- 
tion, this being probably due 
to dilatation of the hepatic 
vessels. 



Johnson holding that the rise 
of arterial tension in angina 
pectoris is not the primary 
cause of that agony, but is 
merely a secondary reflex re- 
sult, and that the remedy 
acts purely in virtue of its 
anti-neuralgic virtues, seeing 
that curative powers are 
equally manifested when face 
flushing already exists. 

Bruntius's views, however, 
would seem most in accord- 
ance with the facts observed, 
but, whichever side is right, 
there can be no doubt about 
the accuracy of the evidence 
brought forward in favor of 
the clinical superiority of this 
over any other treatment. 

Ill* Amyl has been suc- 
cessfully used during the pa- 
roxysm of spasmodic asthma, 
acting, no doubt, by relaxing 
the muscular walls of the 
bronchial tubes, and it has 
also been recommended as an 
efficient remedy for whoop- 
ing-cough, but my own expe- 
rience does not bear this out. 



IV. Amyl has been theo- 
retically recommended in 
cholera, but there is no spe- 
cial evidence in its favor. 



420 BETEL NUT — INDIAN BAEL. 

Amyl is now known to act more speedily and effectually 
when inhaled than when taken by the mouth, and from 2 to 
5 drops placed on a handkerchief are cautiously drawn into 
the lungs until the characteristic flushing is produced. 

No special accidents are recorded as having arisen from 
its use ; but the caution seems a reasonable one, not to re- 
commend it rashly to old persons with brittle or calcareous 
arteries, as the sudden alteration of calibre might be attended 
with danger. Possibly also it might be advisable not to 
recommend it to very plethoric patients, whose brains are 
already fully filled with blood. As it keeps badly, we must 
be very careful to procure it quite fresh, and not expose it to 
sunlight. 

Anasmic patients seem to be specially tolerant of its use. 

(For Nitro-Glyeerine, see page 432.) 



ARECA— [BETEL NUT, Ph. B.] 

This nut possesses some astringent properties, and has 
been used with success as an anthelmintic. 



[AZEDARACH— AZEDARACH. 

The hark of the root of Melia Azedarach, U. S. Secondary. 

The bead-tree, or Pride of China, is largely used in the 
Southern States as an anthelmintic, resembling spigelia in 
its effects. The decoction (^ij to Oij boiled to Oj) is gen- 
erally employed ; the dose to a child being a tablespoonful 
frequently repeated, until it purges.] 



BEL.E FRUCTUS— INDIAN BAEL [Ph. B.] 

Indian bael, containing tannin, has astringent properties, 
and has been highly praised as an effectual cure for the more 
chronic forms of dysentery. Only partial confirmation is 
given by home experience to the evidence furnished from 
abroad ; but this may be explained not only by the limited 
opportunities of testing its efficacy in this country, but be- 
cause the drug is probably much more active when used in 
a perfectly fresh state. 



KOUSSO — CASCA BARK. 421 

BRAYERA— KOUSSO. 

[ The flowers and unripe fruit of Brayera anthelmintica, U. S. 
Secondary."] 

Effects. 
Physiological. Therapeutical. 

The action of kousso is It is therefore occasionally 

poisonous to the tape-worm, used as an anthelmintic, and 

without exerting any irritat- with moderately good effect 

ing or purgative effect. [ a Of when given on an empty 

all the remedies for tape-worm stomach, according to the 

none is more efficient or cer- rules generally laid down, 
tain" (Stille).] 

Mode of Administration, etc. 

It is well not to use the officinal tincture [Br.], but to get 
the fresh flowers, boiling about half an ounce in three or four 
ounces of water, adding a little lemon-peel, and directing 
the patient to swallow the whole draught, dregs and all. A 
little vomiting sometimes follows, but is seldom troublesome. 
[A brisk cathartic should follow in three or four hours.] 



CASCA BARK. 

The bark of Erythrophlozum Guineense, generally called Casca, Cassa, or 

Sassy bark. 1 

This is the ordeal bark of Angola. If the victim vomits 
he is acquitted, if it causes purging he is put to death. 
In an examination into its physiological action by T. Lauder 
Brunton, M.D., F. R. S., and Walter Pye, Esq., fifty-four 
experiments were tried on various animals, and it was 
found to uniformly cause vomiting, weakness, and finally 
death during a convulsion. 

The purgation is probably due to a local action, as it never 
follows subcutaneous injection. The intestinal secretion is 
not increased; respiration is accelerated from stimulation 
of pulmonary branches of vagus, and not from action on 
respiratory centre. On circulation a primary slowing is 
caused from stimulation of the vagi, as it ceases after section 
of these nerves ; and, secondarily quickening, by paralysis 

1 See Phil. Trans, of Royal Soc, vol. 107, part 2, rev. ed., 1870. 
36 



422 WOORARA. 

of the ends of the vagus in the heart, thus resembling the 
action of digitalis. The arterioles contract [either directly 
or] from nervous action, the blood-pressure rises, and the 
secretion of urine is increased. 
Powdered casca is a sternutatory. 



[CURARE— WOORARA. 

South American arrow-poison. 

Dose, gr. T \ (.006 Gm.). 

This is a watery extract of several plants, prominent 
among which are two belonging to the species of strychnos 
and coc cuius (probably Strychnos Castelnce, Wed., and 
Cocculus toxiferuSi Wed.), and a variety of pepper. It has 
the consistence of thick paste, becoming brittle on drying ; 
is blackish-brown in color, and has a bitter taste. It is pro- 
bable that its composition varies in different localities. 

Local Effects. 

Physiological. Therapeutical. 

Curare is an irritant to It is only applied to wounds 

denuded surfaces, causing for its constitutional in- 
pain and inflammation. fluence. 

Constitutional Effects. 

1. Nervous System The 1. In epilepsy and chorea, 

mind remains clear. The curare has been tried and 
inferior extremities are first found to be useless. 

and chiefly affected. " It 
seems probable, however, that 
the primary operation of 
woorara is upon the termina- 
tions of the nerves, and not 
on their central origin." 
(Stille.) 1 

2. Muscular System.-~W\ieT\ 2. This agent has been em- 
injected into the blood, or ployed in almost all forms of 
hypodermically, curare causes muscular spasm, but it is in 
general muscular paralysis, tetanus that it has achieved 

1 The National Dispensatory, Philadelphia, 1879, p. 482. 



TURMERIC. 



423 



first affecting the inferior ex- 
tremities, but ultimately in- 
volves all the muscles, in- 
cluding those of respiration. 
A large dose causes death by 
paralysis of respiration and 
asphyxia, but the heart con- 
tinues beating after the 
breathing ceases, and animals 
may be restored by artificial 
respiration. 

It is apt to cause ptosis in 
man, and mydriasis and di- 
plopia may occur. 



3. Upon Secretion When 

taken by the mouth, curare 
is eliminated by the secre- 
tions nearly as rapidly as ab- 
sorbed, so that it is almost 
innocuous in this way, simply 
acting as a diuretic and . dia- 
phoretic. 



its best results. It is certain 
that it reduces the muscular 
contractions and saves the 
patient from the consequent 
exhaustion. It is reported 
to have cured 13. out of 33 
cases of tetanus, and deserves 
further trial. 

In hydrophobia it also ex- 
erts a good effect by relieving 
the violence of the convul- 
sions and reducing their fre- 
quency. In three cases it 
has been thought to have 
cured patients afflicted with 
rabies canina. 

3. As it is believed that if 
any abrasion or ulcer exist 
in the stomach the drug may 
exhibit its toxic effects, its 
internal use is not considered 
advisable in any considerable 
dose. 



Administration, Dose, etc. 

Curare is best exhibited hypodermically, in order to 
insure exactness of administration. A solution in distilled 
water (one part in one hundred) is the most available form, 
but it should be freshly prepared. Ten minims of this solu- 
tion would be the ordinary dose, to be 'carefully repeated 
until its characteristic effects on the muscular system are 
observed. 

What has been termed the sulphate of curarin has been 
used in doses of one-tenth that of the extract.] 



CURCUMA— TURMERIC. 

\_The rhizome of Curcuma longa, U. S. Secondary.} 

Turmeric is not used in medicine. It forms the coloring: 
ingredient in curries, and the theory has recently been 
broached that the yellowish tint so often observed on the 
skin of Anglo-Indians results from the absorption of the pig- 



424 PURIFIED OX-BILE. 

ment of this substance. [Bibulous paper saturated with the 
tincture and dried, is used as a test for alkalies, which turn 
it brownish-red.] 



EUCALYPTUS GLOBULUS [Ph. B.]. 

Blue Gum- Tree of Tasmania. 

Eucalyptus is an excellent antiseptic, proving rapidly de- 
structive to infusoria. [It may therefore prove useful in 
sarcinous vomiting. The tincture and infusion have both 
been used as applications to foul ulcers.] 

It paralyzes the spinal cord and medulla, a period of pre- 
liminary excitement rapidly giving way to profound muscular 
weakness, loss of reflex activity, and finally death from re- 
spiratory failure. 

The pulse loses in force, the temperature is lowered, and 
the excretion of urea is increased. 

As regards the therapeutics of the drug, it appears to have 
been used with success as an antiperiodic. There seems 
to be no doubt that the presence of the tree in large num- 
bers deprives malarious districts of much of their virulence. 

It has also been recommended in bronchitis and asthma. 

Dose of the tincture, f'3ss to f5ij- [The fluid extract 
may also be used, but the oil is the best preparation. Dose, 
gtt. v-x.] 



FARINA TRITICI— WHEAT FLOUR. 

Flour is only of dietetic importance. Bread-crumb (Mica 
panis) is used as a vehicle for pills. 



FEL BOYINUM PURIFICATUM— PURIFIED 
OX-BILE [Ph. B.]. 

Bile is well known to act It has, therefore, been sup- 
as a laxative, to aid the di- posed that when a deficiency 
gestion of the fatty and amy- of bile is suspected, we may 
laceous constituents of our hope to derive advantage 
diet, and to prevent the de- from ox-gall administered in 
composition of food within gelatine capsules, so that its 
the intestines, with consequent action may be deferred until 
flatus and digestive disturb- it reaches the small intes- 
ance. tines. In some forms of dys- 



JABORANDI. 425 

pepsia and in chronic diar- 
rhoea it is said to be a useful 
remedy, but little clinical evi- 
dence on this point can be 
adduced. 



GOA POWDER— [ARAROBA]. 

Has been extensively used in the East, recommended by 
Sir Joseph Fayrer in cases of ringworm and psoriasis. We 
may dissolve a scruple in an ounce of hot lard to make an 
ointment. 

Prof. Attwood having discovered that chrysophanic acid 
is the principal ingredient of Goa powder; Mr. Balmanno 
Squire has proved the efficacy of this substance in the same 
class of cases, making an ointment also with hot lard (in the 
proportion of 3ij t0 Ej)- 

Chrysophanic acid has been found a valuable remedy, 
more especially in psoriasis, acne, and parasitic skin affec- 
tions. If used too strong, it may cause much smarting, with 
irritation of the skin, and an irritable crop of papules. [It 
will produce conjunctivitis if introduced into the eye.] 

Mr. Ashburton Thompson 1 has pointed out that chryso- 
phanic acid is an emetic purge of great efficiency, acting 
rapidly, and without much depression. 



JABORANDI. 

[Dose of the drug, gr. x to 5j (>65 to 4. Gm.).] 

Preparations (not Officinal). 

Piloearpia, gr. i to i (.001 to .03 Gm.). 

Elixir Jaborandis (gr. x to 3j). Dose 5j to iv (or 

4. to 16. Gm.). 

Constitutional Action. 

Physiological. Therapeutical. 

Within ten or twelve min- The powerful diaphoretic 

utes after jaborandi has been action of jaborandi, no less 

taken, the face flushes deeply, than its power in aiding the 

and profuse perspiration fol- elimination of urea, would 

1 British Medical Journal, May, 1877. 
36* 



426 



JABORANDI. 



seem to suggest its use in va- 
rious chronic kidney-diseases 
[Bright's disease], as well as 
febrile conditions. But its 
action is too short, sharp, and 
sudden, and too much depres- 
sion and inconvenience are 
produced, to render us very 
hopeful of its ultimate success 
in practice. 

It has been precribed in 
diabetes insipidus, and for 
the purpose of augmenting 
the secretion of milk. 



lows, accompanied by a great 
increase of salivary secretion, 
terminating in from two to 
four hours. The loss of fluid 
thus produced is very con- 
siderable, and the sweat has 
been proved to contain a 
large excess of urea. This 
action on the skin is consi- 
dered due to vaso-motor para- 
lysis and consequent dilata- 
tion of the cutaneous arteri- 
oles, and the sialagogue effects 
of the drug are attributed to 
stimulation of the periphery 
of the nerves supplied to the 
salivary glands. Jaborandi 
increases somewhat the action 
of the heart ; and contraction 
of the pupil, with impaired 
accommodative power, has 
been noted to attend its use. 

A good deal of nausea, de- 
pression, and general discom- 
fort result, and have been 
graphically described by Mr. 
Martindale in the " Lancet." 

Atropia and muscarine ap- 
pear to be in many respects 
an exact physiological anti- 
dote to jaborandi. 

[The alkaloid of Jaborandi, possessing both the diapho- 
retic and sialagogue properties of the drug, has received the 
name of — 

Pilocarpia — Pilocarpin. 

Constitutional Effects. 



Physiological Effects. 

Dr. Popow (St. Peter sb. 
Med. Woch., August 4), re- 
porting upon the results de- 



Therapeutic Uses. 

From some comparative 
trials which he has made 
with the internal administra- 



JABORANDI. 



427 



rived from the hypodermic 
injection of pilocarpin in men 
in health and suffering from 
fever, and in experiments 
upon animals made in Prof. 
Suschtschinsky's laboratory, 
comes to the following con- 
clusions : — 

1. Pilocarpin produces the 
same effect as an infusion of 
the leaves of jaborandi. 

2. An injection of from 
gr. -J- to J (.01 to .02 Gm.) 
induces abundant sweating, 
without causing the unpleas- 
ant effects (giddiness, vomit- 
ing, cephalalgia) produced 
by jaborandi, and is, there- 
fore, better suited for thera- 
peutical employment. 

3. The temperature dimin- 
ishes without any prior ex- 
altation, from one hour and 
a half to four hours, and 
reaches its minimum soon 
after the cessation of the 
sweating. 

4. The increased excretion 
of saliva is observed alike in 
the healthy and the sick, 
after doses of from gr. |- to ^ 
(.01 to .015 Gm.). Sweat- 
ing only occurs in such doses 
in the healthy; fever pa- 
tients, e. g., typhus, requiring 
gr. $ (.02 Gm.). 

5. The quickening of the 
heart's action produced by 
the pilocarpin continues a 
pretty long time after small 
doses, but when large ones 
are employed, this is soon 
replaced by retardation. 



tion of pilocarpin, Dr. Cursch- 
mann believes that the infre- 
quency with which it causes 
vomiting, as compared with 
jaborandi, is principally due 
to its being used hypoder- 
mically, and thereby avoid- 
ing direct irritation of the 
stomach. Some persons, es- 
pecially those who have been 
weakened by prior disease, 
complain of a sense of debi- 
lity, but this usually soon 
passes off; but in others a 
complete state of collapse is 
produced, which may or may 
not be connected with prior 
vomiting. The possibility of 
this occurrence must always 
be borne in mind. It is de- 
pendent upon the amount of 
the dose and the susceptibi- 
lity of the individual. It is 
oftenest met with in women, 
and in those whose strength 
has been greatly reduced ; 
and when the patient's con- 
stitution is not known, the 
first dose of the medicine 
should not exceed gr. ^ (.02 
Gm.), while its effect should 
be watched for a quarter or 
half an hour. As far as the 
trials have gone, pilocarpin 
does not seem to act danger- 
ously on the subjects of heart- 
disease, and, indeed, can be 
employed when no other dia- 
phoretic procedure, for so 
long a period, would be ven- 
tured upon. Indeed, as a 
therapeutical agent for the 
production of diaphoresis, it 



428 



JABORANDI. 



6. On the direct introduc- 
tion of pilocarpin into the 
veins a retardation of the 
heart's action takes place 
suddenly, without any prior 
acceleration. 

7. Doses not exceeding 
gr. 1 (.03 Gm.) do not exert 
any particular effect on the 
alimentary canal ; but large 
doses, gr. f to gr. jss (.05 to 
.10 Gm.), induce purging, or 
even bloody stools, with in- 
testinal movements, and the 
development of gases. 1 

The quantity of urine and 
the amount of urea are both 
increased during the twenty- 
four hours succeeding its ad- 
ministration. 2 



is superior to any other me- 
thod in use, being more 
easily employed, while its 
action is more certain and 
more complete, without being 
more, or even as dangerous, 
as most of them. Its supe- 
riority over the various 
sweating-baths in ascites, hy- 
drothorax, asthma, etc., is 
most marked. It is true 
that diaphoretic treatment is 
thought less of than formerly ; 
but in several cases the diffi- 
culty of its application, rather 
than its inefficacy, is the 
cause of its not being resorted 
to. Speaking from his own 
experience, Dr. Curschmann 
has found the pilocarpin very 
useful in oedema, in dropsy 
of the cavities from heart or 
lung disease, and in chronic 
nephritis, etc., and that after 
diuretic, drastic, and other 
means have failed. He be- 
lieves that a large field for 
its employment may be found 
in pleurisy accompanied by 
serous exudation, both in 
promoting the absorption of 
this, and in preventing its re- 
accumulation after paracen- 
tesis. It is evidently indi- 
cated in chronic rheumatic 
affections, at least so far as 
these are amenable to dia- 
phoretic treatment. 3 



1 [Medical News and Library, Phila., Oct. 1877, p. 154; from 
the Med. Times and Gaz., Aug. 25, 1877.] 

2 [Drs. Tyson and Bruen, Am. Journ. Med. Sciences for July 1, 
1877.] 

3 [Phila. Med. and Surg. Reporter for Oct. 6, 1877.] 



JABORANDI. 429 

Prof. Demme, 1 of Berlin, thus summarizes his experience 
in the dropsical affections of children. The remedy was ad- 
ministered subcutaneously in doses of gr. y 1 ^ to -J (.005 to .02 
Gm.) :— 

1. Pilocarpin is an efficacious diaphoretic and sialagogue 
in the treatment of certain diseases of children. 

2. In appropriate doses it is well borne by the youngest 
patients. 

3. Unpleasant symptoms are of very rare occurrence, and 
can probably be altogether prevented by administering small 
doses of brandy before the injection. 

4. The cases for which pilocarpin is especially suitable are 
the parenchymatous inflammations of the kidney with dropsy, 
following scarlatina and diphtheria. In the majority of cases 
the flow of urine is decidedly increased, while the quantity 
of blood and albumen in the urine is diminished rather than 
augmented. 

It is uncertain whether pilocarpin has any direct influence 
upon the action of the heart. 

Mode of Action on Salivary Glands. 

Mr. J. N. Langley (Journal of Anatomy and Physiology, 
Oct. 1876) gives the following as the results of experiments 
made by him to determine the action of pilocarpin on the 
submaxillary gland of a dog : — 

"In small doses, i.e. up to gr. -^ (.03 Gm.), pilocarpin 
exerts an action on the gland very similar to that produced 
by stimulation of the chorda tympani. 

" It causes a rapid secretion and a considerable increase 
of blood-flow 7 , both secretion and blood-flow afterwards gradu- 
ally declining. 

u Its effects are little if at all altered by sections of the 
chorda tympani or of the sympathetic nerve. Stimulation 
of the chorda tympani increases the pilocarpin effects, i. e. 
the nerve is functionally unaltered. Stimulation of the sym- 
pathetic diminishes its effects, so that this nerve, too, is func- 
tionally unaltered. The secretion is stopped by injecting 
atropia (a fact for some time known), but a quantity of 
atropia sufficient to paralyze the chorda tympani does not 
prevent a relatively large quantity of pilocarpin from pro- 
ducing its ordinary results. In fact, the secretion or absence 

i [Med. Exam., July, 1878.] 



430 SOLUTION OF DIALYZED IRON. 

of secretion is dependent on the relative quantity of the two 
poisons present. 

" In larger doses, instead of causing a stronger saliva- 
flow, it causes none at all, and further prevents the chorda 
tympani from producing any secretion. It considerably 
diminishes the blood-flow through the gland, as well as the 
effects of the chorda tympani on the blood-flow. 

" It does not, however, stop the sympathetic secretion. 
This action indeed is not very dissimilar to that of atropia; 
which agrees with its action on the vagus and inhibitory appa- 
ratus of the heart, where in large doses it prevents any inhi- 
bition of the heart from stimulation of the vagus, or of the 
junction of the sinus venosus, just as atropia does." 1 

Mode of Administration, and Dose. 

The infusion of the powdered leaves is a good method of 
exhibiting the drug. A drachm should be steeped in half a 
pint of hot water, and when sufficiently cool stirred up and 
one-half the quantity drunk, half an hour later the remainder 
should be taken, without straining the infusion. This is 
generally sufficient to cause profuse sweating within an hour. 
Ptyalism is less constant in its occurrence. Experience, 
however, is in favor of using some of the following prepara- 
tions in preference to the crude drug, as being more reliable 
and agreeable. 

Pilocarpin is conveniently administered by hypodermic 
injection. Gerrard found that the nitrate and hydrochlorate 
of pilocarpin in doses of one-half a grain, also produced the 
full effects of jaborandi in substance. 

The fluid extract of jaborandi is now largely used, the 
dose being a fluidrachm, representing a drachm of the leaves. 
An elixir is also made by some pharmacists containing the 
virtues of one drachm in six fluidrachms. Dose f3J-f ^ss.] 



[LIQUOR FERRI DIALYSATUS— SOLUTION OF 
DIALYZED IRON. 

This preparation is of recent introduction, and has been 
well received. When well made it is a clear, neutral, very 
deep wine-colored liquid, free from taste and apparent as- 

1 [Am. Journ. Med. Sciences, Jan. 1877.] 



KAMALA — LARCH BARK. 431 

tringency, and bearing perfectly dilution with pure water. 1 
It is a pure and powerful chalybeate with all the advantages 
of iron in the usual form ; it is borne well by the stomach, 
and does not cause constipation nor distress the digestion. 
Chemically it would appear to be a ferric hydrate kept in 
solution by a small quantity of ferric chloride. It is made by 
precipitating ferric chloride with dilute water of ammonia, 
washing the ferric hydrate precipitated, dissolving it in a 
solution of ferric chloride, and placing the result in a dialyzer. 
Graham, the inventor of the process, believed that muriatic 
acid passes through the dialyzer, mainly, and that the iron is 
left in the form of the soluble, colloidal, ferric hydrate ; but 
in practice it has never been obtained entirely free from the 
chloride. Dialyzed iron would seem to furnish us with an 
efficient substitute for the hydrated sesquioxide in the treat- 
ment of poisoning by arsenious acid. It is precipitated by 
various salts, and should be administered alone in doses of 
from ten drops to a drachm, after meals. It claims to con- 
tain about the same proportion of iron as the muriated tinc- 
ture, and, as it is said not to injure the teeth, it proves an 
admirable substitute for it, in chlorosis, ancemia, and allied 
conditions. 2 ] 

ROTTLERA— KAMALA, U. S. Secondary. 

[ The glandular poivder and hairs obtained from the capsides of Rottlera 
tinctoria (Roxburgh), U. S. 

Dose, 5j-iij (4. to 12. Gin.).] 

Effects. 

Physiological. Therapeutical. 

Kamala is a vermicide, Kamala is an efficient an- 

killing the tape-worm rapidly; thelmintic, differing from 

it also possesses purgative other remedies of the class 

properties. in its cathartic action. 



LARICIS CORTEX— LARCH BARK [Ph. B.]. 

Larch bark is seldom if ever used in medicine. 

1 [Phila. Med. Times, vol. vii. p. 492, article on Dialyzed Iron.] 
a See article on the " Hsematinic Properties of Dialyzed Iron," by 

Dr. Robt. Amory, in Boston Med. and Surg. Journal for April 3, 

1879, vol. c. p. 453. 



432 NITROGLYCERIN. 

LAUROCERASI FOLIA—CHERRY-LAUREL 
LEAVES [Ph. B.]. 

The distilled cherry-laurel water contains prussic acid, 
but, as it is very variable in strength, its use cannot be ad- 
vised. 



MORI SUCCUS— MULBERRY JUICE [Ph. B.]. 
Is only used as a flavoring ingredient. 



[NITROGLYCERINUM—NITROGLYCERIN. 

Trin itroglycerin , Glonoin . 

A pale, yellowish, oily liquid, crystallizing in needles at 
a low temperature, and has a density of 1.60 (59° F.). It 
is nearly insoluble in water, but dissolves freely in ether 
and alcohol, forming compounds that explode on percussion. 
It is the basis of various blasting compounds such as dyna- 
mite, glyoxylin, dualin, etc. 

Internal Effects. 

Nitroglycerin is a poison exerting a marked effect on the 
nervous system, even when given in minute doses, producing, 
according to Brunton and Tait, "accelerated respiration, 
paralysis, loss of reflex action, and, apparently to a great 
degree, of sensation, and death from stoppage of the respi- 
ration." In frogs, after death, the brain is anaemic and 
heart empty, but the lungs are engorged with blood. 

Medical Uses. 

It has been recommended for epilepsy, headache, and 
asthma; it has no smell, but its vapors cause intense head- 
ache. 1 Of late it has been highly praised by Dr. Murrell 
for the relief of angina pectoris. Used in drop doses of a 
one per cent, solution and cautiously increased, marked 
effects are produced, it is said, and decided relief afforded. 2 ] 

1 [National Dispensatory, Philadelphia, 1879, p. 939.] 

2 [The Practitioner, London, 1879, vol. xxii. p. 208. J 



NITROUS OXIDE GAS — PEPSIN. 



433 



NITROUS OXIDE GAS. 

[Made from nitrate of ammonia by heat.~\ 



Physiological Action. 

Laughing-gas has been 
generally introduced as an 
anaesthetic, a very brief inhala- 
tion causing perfect insensi- 
bility, preceded occasionally 
by slight excitement, and at- 
tended by an amount of livid- 
ity which at first sight seems 
most alarming. It has been 
shown that this insensibility 
is simply a condition of modi- 
fied asphyxia, as during nar- 
cosis only two-thirds of the 
normal amount of carbonic 
acid is given off, and imme- 
diately after recovery only 
one-third. 



Therapeutical Action. 

Nitrous oxide gas is very 
valuable for the performance 
of such small operations as 
tooth extraction ; but anaes- 
thesia cannot safely be kept 
up long enough to render it 
available during more pro- 
longed surgical manipula- 
tions. During its adminis- 
tration we must rigidly ex- 
clude all atmospheric air, and 
thus prevent those violent 
and varied evidences of ex- 
citement which have so often 
caused amusement during the 
old-fashioned inhalation of 
laughing-gas. 

A popular mode of procur- 
ing anaesthesia now is to take 
advantage of the rapid action 
of this gas in the first in- 
stance, and then continue the 
process by means of ether. 



[PEPSINA PORCI]— PEPSIN 



Pepsin is the most import- 
ant digestive element of the 
gastric juice, and more espe- 
cially reduces the albuminoid 
and proteinaceous constitu- 
ents of food to a fit state for 
absorption. 

Pepsin probably acts, in 
part at least, by stimulating 
the secreting function of the 
stomach mucous membrane. 

37 



There can be little doubt 
that many dyspeptic condi- 
tions are due to a deficiency 
of gastric juice, and attempts 
may be made to supply this 
by prescribing pepsin, prefer- 
ably in combination with di- 
lute hydrochloric acid. 

In atonic dyspepsia, in va- 
rious ancemic and cachectic 
conditions, in the diarrhoea 
of children, in some forms of 



434 SALICIN. 

The ordinary pepsin wines spasmodic asthma, its use 
rapidly become inert, because seems to be attended with 
the alcohol does not prevent good results ; but we may 
the ferment from changing, well share Dr. Wood's scep- 
glycerine alone having this ticism as to the possibility of 
power. materially aiding the diges- 

tion of food by the small 
doses usually prescribed. 

Pepsin has also been re- 
commended as an addition 
to nutritious enemata, so as 
to insure some preliminary 
digestion of the injected food. 

Dose, gr. ij-v (.12 to .30 Gm.). Or we may use Prof. 
Liebreich's Pepsin-Essenz. [It may be conveniently pre- 
scribed in the form of Saccharated Pepsin, Liquor Pepsini, 
Boudault's Acid Pepsin, or as Lacto-peptine.] 



[PETROSELINUM— PARSLEY. 

The root of Petroselinum sativum (Lindley, Flor. Med.), 
U. S. Secondary . 

The neutral active principle, Apiol, has attained some 
reputation in the treatment of inter mittents, and is also 
used in neuralgia and dysmenorrhea. Its nauseating taste 
requires it to be given in capsule (gr. 3 T 9 y). Dose, one to 
four.] 



RHAMNI SUCCUS— BUCKTHORN [Ph. B.]. 

Buckthorn has some purgative properties, but is almost 
never used in modern practice. 



SALICIN. 

Salicin acts as a bitter tonic, and has some antiseptic and 
antiperiodic qualities, which have caused it to be used, with 
only partial success, in the treatment of malarial affections. 
Recently, however, it has been most extensively employed, 
on the recommendation of Dr. Maclagan, as a remedy for 
acute rheumatism, in which disease from 10 to 30 grains, 



SALICYLIC ACID. 



435 



every two, three, or four hours, in powder mixed with water, 
generally succeeds, within forty-eight hours, in relieving 
pain and reducing temperature. It is also a useful remedy 
in neuralgia. 



ACIDUM SALICYLICUM— [SALICYLIC ACID. 

Sodii Salieylas. Dose, gr. xx to 5j (1-30 to 4. Gm.). 
Ammonii Salieylas. Dose, the same.] 



Local Actions. 



Physiological. 

Salicylic acid is an excel- 
lent antiseptic, delaying pu- 
trefaction and preventing de- 
composition. 



Therapeutical. 

Being less irritant than 
carbolic acid, it has been 
proposed as a substitute for 
that substance in carrying 
out Lister's antiseptic sys- 
tem. It has also been rec- 
ommended as a good lotion 
to raw surfaces ; but Callen- 
der has shown that it not 
only tends to irritate the 
wounds, but frequently brings 
out a crop of irritable vesicles 
in their neighborhood. [It 
has been used as an applica- 
tion in croup, in powder or 
solution.] 



Constitutional Action. 



Salicylic acid is an anti- 
septic and antipyretic, rapidly 
reducing temperature in fever- 
ish conditions, although, in a 
state of health, the drug seems 
to be without influence on the 
body heat. Some headache, 
giddiness, and ringing in t he 
ears have been observed, but 
the cardiac and respiratory 



Salicylic acid is now uni- 
versally allowed to be a most 
efficient remedy in acute 
rheumatism, very rapidly re- 
ducing temperature, relieving 
pain, and, in fact, cutting 
short the disease. By short- 
ening the duration of the 
joint inflammation, it natu- 
rally limits the tendency to 



436 



SALICYLIC ACID. 



functions are not sensibly 
affected. 

In poisonous doses, slow- 
ing of the breathing and con- 
vulsive attacks, from diminu- 
tion of the excitability of the 
vagus, have been observed. 
Nausea, burning in the throat, 
vomiting, and stomach irrita- 
tion have occasionally been 
noticed to follow the use of 
the acid ; and albuminuria 
with almost total suppression 
of urine, and occasionally 
hematuria are more rarely 
noted among its effects ; the 
most usual action, however, 
on the kidneys being diuretic, 
with slight increase of urea 
and uric acid. 



cardiac complication ; but it 
seems to have no influence 
over developed pericarditis, 
or in averting or arresting 
conditions of hyperpyrexia. 
In an ordinary case of acute 
articular rheumatism, we may 
count upon cutting short the 
disease in two or three days, 
the pain going first and then 
the fever. It is well to con- 
tinue the drug for 10 or 15 
days after the apparent cure, 
in order to prevent relapses, 
and the anaemia so often fol- 
lowing other modes of treat- 
ment is not met with under 
this. It is of less service in 
chronic rheumatism or gout, 
it is useless in ague, and al- 
though in typhoid fever the 
temperature may go down, no 
influence is exerted on the 
duration of the disease. 



Mode of Elimination. 

Elimination is effected by the urine, beginning in 10 
minutes and being completed in from 24 to 48 hours, and 
the acid seizing glycocol from the liver and other organs 
becomes converted into salicyluric acid, thus resembling the 
conversion of benzoic into hippuric acid. Probably a little 
is also given off by the sweat and saliva. The soda salt is 
rapidly transformed into the original acid by the carbonic 
acid of the blood. 



Dose and Mode of Administration. 

We may give salicylic acid in 20-grain doses, repeated 
hourly for six hours on two successive days and continued at 
shorter intervals if the disease resists 48 hours' medication. 
As much as 280 grains have been given without injury 
within 12 hours, but it is always well to avoid very large 
doses, which are very apt to cause irritation and discomfort. 



SALICYLIC ACID. 437 

Salicylic acid, being irritating and very insoluble, has been 
now almost entirely displaced by the salicylate of soda, which 
is freely miscible with water and is readily absorbed ; the 
dose being gr. xx to 5J (1-30 to 4. Gm.), being generally 
administered in the smaller dose every hour until a drachm 
has been given daily. 

Dangers from Salicylic Acid. 

[Several instances have occurred in which this agent has 
unexpectedly produced disagreeable consequences. Dr. 
Watelet communicates a paper to a late number of the 
Bull, de Therapie on this subject, in which the details are 
given of two cases of rheumatism treated by salicylate of 
soda, one of which was followed by gangrene of the lower 
extremities, and both by cystitis, obstinate constipation, and 
coldness of the extremities. 1 

Salicylic acid has a strong affinity for lime, and it is 
thought that its administration if long continued may inju- 
riously affect the bones and the teeth. Whether this tech- 
nical objection also exists against it when given in combina- 
tion with alkalies, is not clear, but in this form it is certainly 
safer, and these salts are now generally used in preference 
to the acid itself.] 

Since these alkaline salts have come into general use, we 
have heard much less of the uncomfortable effects occasion- 
ally caused by the acid, and some of which, at all events, 
were due to impure preparations containing carbolic or 
cresylic acid. But, in addition to the peculiarities men- 
tioned above, careful observers have described urticaria and 
irritable erythematous and vesicular, cutaneous affections and 
sore throat, with a species of quiet delirium and feverish 
symptoms, and we are specially warned to beware of its use 
in kidney disease. As a general rule, however, the soda 
salt may be freely prescribed without the anticipation of any 
of these undesirable results. 

Salicylic acid is very insoluble, and it is difficult to find a 
ready medium for its administration. Messrs. Savory and 
Moore have devised a very elegant granular, effervescing 
preparation, or we may use the salicylate of sodium or 
ammonium. The following are good formulae : — 

1 Dublin Press and Circular. 
37* 



438 



SUMBUL — THYMOL. 



R. Acidi salicylici 

Olei amygdalae expressi 
Pulv. acacia? 
Syrupi amydalae 
Aquae aurantii flores 
S. Capiat f 3j pro dosi. 
For children. 

Or, 

R. Acidi salicylici 

Sp. rect. 
Dissolve. 



3.1; 


or 


4 


*5v; 


it 


20 


3ijss ; 


a 


10 


f 3vj ; 


a 


24 


ad f !§iij ; 


a 


96 



Gm. 



M. 



3j ; or 

fgijss; " 



4 
10 



Gm. 



Potassii citratis f £j ; or 4 " 

Syrupi aurantii f 313 ; " 8 " 

Aquae f3iijss; " 10 " 
S. Mix the two solutions and filter, and then dilute with water 
to taste. 

[The following is used by Da Costa quite extensively in 
acute rheumatism: — 



R. Sodii salicylatis gr. xx ; 

Glycerinae TH_xv ; 

Spt. lavandulae comp. rr^vijss ; 

Aquae ad §ss ; 

To he taken every three or four hours.] 



or 



1 
1 

16 



30 Gm. 
n 

50 " 



M. 



SUMBUL 

Has antispasmodic properties, but is very rarely prescribed. 



THYMOL. 

This is an excellent antiseptic, more powerful than car- 
bolic acid and ten times less poisonous, and it is much less 
irritating. 

Prof. Volkman has used it instead of carbolic acid in car- 
rying out Prof. Lister's antiseptic plan, and recommends the 
folio win 2 solution : — 



Gm. 



M. 



]$. Thymol. 




gr. xv ; 


or 


1 


Alcoholis 




3-iJ ss ; 


1 ( 


10 


Glycerinae 




3v; 


a 


20 


Aquae 




Oij; 


a 


1000 


To be used as a 


spray. 









It has also been found a good application in eczema and 

psoriasis. 



LEECHES. 439 

TRIMETHYLAMINE AND ITS HYDRO- 
CHLORATE. 

Dose of the hydrochlorate, gr. iij-x (.20 to .Q5 Gm.). 

Lowering of temperature and pulse is said to follow the 
use of this drug, and it has been much recommended as a 
remedy for acute rheumatism. 



LEECHES. 

[Hirudo. Sangidsuga Officinalis.'] 

Leeches are undoubtedly the most convenient means for 
the local abstraction of blood, and are used to relieve pain, 
which they do very effectually in certain local inflammations, 
as pleurisy, pericarditis, orchitis, iritis, hepatitis, perito- 
nitis : and there is reason to believe that, when applied 
sufficiently early, they may even moderate the inflammatory 
process. Their action, no doubt, may frequently be ex- 
plained by direct vascular communication between superficial 
vessels and those of deeper parts. 

Each leech may contain about 1-g- dr. of blood, and subse- 
quent fomentation may draw so much more from the skin as 
to raise the total amount up to half an ounce. Should the 
subsequent bleeding prove difficult of arrest, as sometimes 
happens, we may succeed in staunching the flow by means 
of pressure, cold, various astringents, the application of solid 
nitrate of silver, or the twisted suture. [The American 
only takes about one-third as much blood as the imported 
leech, and, on this account, is preferred by some in the treat- 
ment of diseases of children.] 

Special cautions in the use of leeches are — never to apply 
them, if possible, to any part over which firm pressure can- 
not subsequently be made, as the larynx ; not to apply them 
in the evening, when, for some unexplained reason, the 
bleeding is more apt to be troublesome ; and, of course, 
never to allow their use in any victim of the hemorrhagic 
diathesis. 

If leeches will not bite, we must smear the skin with 
cream or freshly-drawn blood, or immerse the animal itself 
in porter, which seems to have a stimulating effect ; and 
should one be accidentally swallowed, we can kill it, and 
cause its expulsion from the stomach, by common salt. 



440 poisons. 

[POISONS. 

A poison is a substance, of animal, vegetable, or mineral 
nature, which, when administered in small quantity, is capa- 
ble of producing deleterious effects upon the human system. 
It may be introduced into the economy in a gaseous, liquid, 
or solid form, through any of the channels of absorption, 
though more commonly by the gastro-intestinal tract. 1 

Genral Antidote for Poisoning when the Nature 
of Poison is Unknown. 

I£. Magnesiae, 

Pulv. car bo. ligni, 
Ferri oxidi rubri, ail. M. 
To be given freely in a sufficient quantity of water. 

Or, as suggested by Jeannel — 

Calcined magnesia, §ij ; 

Washed animal charcoal, §j ; 
Water, §xx ; 

to be kept well covered ; when exhibited to be mixed with 

Solution of ferrous sulphate (sp. gr. 1.45) §ijss, and well agitated. 

Given in doses of ^jss-iij in poisoning by arsenic, zinc, the alka- 
loids, etc. 2 

This preparation is harmless, but is effective, for its ingre- 
dients are antidotes to the most common and active poisons. 
With it may be given demulcent drinks, such as milk or 
flour and water, to dilute the poison and protect the stomach.] 

' See title Antidotes for general considerations, page 51. 
2 The Practitioner's Reference Book, R. J. Dunglison, Phila., 1877, 
p. 228. 



treatment of poisons. 441 

[Prompt Treatment Table of Poisons. 

Arranged alphabetically for ready reference. 

Acetic Acid. — The alkaline carbonates, chalk, or magnesia. 
Vomiting should be encouraged and demulcent drinks freely 
given. 

Aconite. — Active emetics, or stomach-pump. Stimulation exter- 
nally and internally. Digitalis is a physiological antidote ; also 
finely-powdered animal charcoal, or tannin, and astringent in- 
fusions. 

Alcohol. — Stomach-pump ; cold affusion ; inhalation of vapor or 
hypodermic injection of ammonia; use of electricity, etc. 

Alum, and Sulphate of Alumina and Potassa. — Warm dilute drinks 
to produce emesis ; hydrate of magnesia, or weak solution of car- 
bonate of ammonia ; stomach-pump. 

Ammonia. — Vegetable acids, as dilute vinegar or lemon-juice ; olive 
oil ; milk given copiously ; stomach-pump should not be used. 

Amylene. — Same treatment as for chloroform poisoning. 

Antimony and its Salts. — Tannin, as in tincture or infusion of 
cinchona, infusion of green tea, or of galls. Free vomiting with 
warm mucilaginous drinks, or stomach-pump. Opium, and in- 
ternal and external stimulation may be employed subsequently. 

Arsenious Acid. — Hydrated sesquioxide of iron, to be given in a 
moist state, in table-spoonful doses, followed by castor oil. (The 
hydrate may be extemporaneously prepared by adding aqua 
ammonise to dilute tinctura ferri chloridi.) Solution of dialyzed 
iron, and freshly-precipitated hydrate of magnesia have also been 
employed. These are not reliable if the arsenic has been taken in 
form of powder. In the absence of vomiting, prompt emesis by 
sulphate of zinc or warm mustard and water. Warm demulcent 
drinks. 

Barium, Salts of. — Sodium or magnesium sulphate ; emetics and 
stomach-pump. 

Belladonna. — No reliable chemical antidote ; tannin and animal 
charcoal have been employed. Physiological antidote, morphia, 
which may be administered subcutaneously. Usual treatment 
for narcotic poisons. 

Bismuth Subnitrate — Albumen, milk, sugar, mucilaginous drinks. 

Brucia. — Same treatment as for poisoning by mix vomica. 

Calabar Bean. — Physiological antidote, atropia, cautiously admin- 
istered hypodermically. 

Camphor. — Emetics, stimulants, wine, and opium. 

Cantharides. — Free emesis to be encouraged with warm demulcent 
drinks ; castor oil ; demulcent injections. 

Carbolic Acid. — Saturated solution of saccharate of lime has been 
recommended as an antidote. Early use of the stomach-pump. 
Olive oil ; flour and water, etc. 

Carbonic Acid Gas. — Artificial respiration, friction, stimulants, 
fresh air, and electricity. 



442 TREATMENT OF POISONS. 

Chloral. — Stomach-pump ; stomach well washed out with tea or 
coffee. Diffusible stimulants. General treatment same as for 
opium poisoning, or poisoning by chloroform vapor. 

Chloroform. — In poisoning by liquid chloroform, use the stomach- 
pump and emetics. If collapse occur during anaesthesia, re- 
verse the patient as recommended by Gross. Ammonia by inha- 
lation, ice in rectum, hypodermic injections of brandy and am 
monia, etc. 

Chromium, Compounds of. — Magnesium carbonate or chalk, in 
milk, albumen, or water, followed by emetics. 

Citric Acid. — Alkaline carbonates, chalk, or magnesia. 

Cocculus Indicus. — Mucilaginous drinks, stimulants, and emetics. 

Colchicum. — Prompt emesis, castor oil, demulcents, opium, and 
stimulants. 

Conium. — Mustard and warm water. Active stimulation, exter- 
nally and internally. 

Copper, Preparations of. — x\ntidote, white of eggs freely admin- 
istered, or milk. Vomiting should be aided by warm muci- 
laginous drinks ; stomach-pump if necessary. 

Corrosive Sublimate. — Albumen, mixed with water and given 
copiously, forms insoluble compound ; white of one egg neutral- 
izes four grains of corrosive sublimate. Gluten, or wheat flour 
paste, or milk, also employed. Free vomiting aided by warm, 
diluent drinks ; stomach pump to be used with caution — may 
produce perforation. 

Creasote. — Emetics or stomach-pump ; demulcent and mucilagi- 
nous drinks. 

Croton Oil. — Same general treatment as for other irritant poisons, 
to counteract excessive vomiting and purging. Opium, stimu- 
lants, demulcents. 

Curare. — Same general treatment as that mentioned for poisoning 
by narcotics ; artificial respiration, hot coffee, etc. 

Cyanide of Potassium. — See Potassium. 

Digitalis. — Vegetable infusions containing tannic acid render the 
active principle insoluble. Give emetics and hot applications to 
surface. 

Ether, Vapor of. — Cold affusion ; exposure to current of air ; arti- 
ficial respiration. 

Gold, Preparations of. — Sulphate of iron ; mucilaginous drinks. 

Hydrochloric Acid. — See Muriatic Acid. 

Hydrocyanic Acid. — Mixture of protosulphate and sesquisulphate 
of iron (ferrous and ferric sulphate), followed by solution of 
potassium carbonate. Being rapidly fatal, treatment must bef 
instantaneous. Cold affusion ; cautious inhalation of ammonia 
and chlorine vapors ; stimulation externally and internally. 

Hyoscyamus. — Same general treatment as for poisoning by bella- 
donna and vegetable narcotics. 

Iodine. — Starch, or flour, in water. 

Iron, Chloride and Sulphate. — Magnesia, copious diluent drinks. 

Lead Salts. — Zinc sulphate, producing free emesis, and forming 
insoluble lead sulphate. Milk and white of egg, given copiously, 
form insoluble compounds. Solutions of magnesium or sodium 



TREATMENT OF POISONS. 443 

sulphate, freely administered, act as antidotes and cathartics ; 
castor oil may also he administered.^ 

Lobelia. — Emetics, purgatives, stimulants. 

Methylene, Bichloride of. — Same treatment as for poisoning hy 
chloroform vapor. 

Morphia. — See Opium. 

Muriatic or Hydrochloric Acid. — Solution of alkaline carhonates 
in water or milk ; magnesia or chalk suspended in milk ; soap- 
suds ; scrapings from whitewashed wails (in the ahsence of other 
articles) ; free use of harley water, oily emulsions, gruel, and 
milk in large quantities. 

Nitrate of Potassium. — See Potassium. 

Nitric Acid and Nitromuriatic Acid. — Same treatment as already 
detailed for poisoning by muriatic acid. Dilute solution of 
sodium carbonate, or fluid magnesia, with water, and milk or 
demulcents may be given. 

Nitrous Oxide. — Same general treatment as for poisoning by chlo- 
roform vapor. 

Nux Vomica. — See Strychnia. 

Oil of Bitter Almonds. — Same treatment as for hydrocyanic-acid 
poisoning. 

Opium, and its Preparations. — Antidotes, tannic acid and iodated 
iodide of potassium. Physiological antidote, solution of atropia 
or tincture of belladonna. Treatment, direct emetics, as large 
doses of zinc sulphate, repeated if necessary, or mustard and 
warm water, or stomach-pump. For the narcotic effect of the 
drug, affusion with cold water, walking the patient, arousing 
him by shaking and shouting ; flagellations ; enemata of strong 
coffee. If unsuccessful, electricity and artificial respiration. 

Oxalic Acid. — Avoid the use of alkalies or their carbonates, as 
they form poisonous salts with the oxalic acid. Give chalk or 
calcined magnesia, or its carbonate, suspended in water or milk, 
which forms insoluble and inert earthy oxalates ; or saccharated 
solution of lime. After-treatment, mucilaginous drinks, lime- 
water, and oil ; warmth and stimulants. 

Phosphorus. — Free vomiting ; albuminous and mucilaginous drinks, 
in which hydrate of magnesia is suspended. Oil, being a solvent 
of phosphorus, should be avoided. Old oil of turpentine (con- 
taining oxygen), oxygenated water, oxygen inhalations, animal 
charcoal, have been employed as antidotes. 

Physostigma. — See Calabar Bean. 

Potassa. — Mild vegetable acids, as dilute vinegar or lemon-juice ; 
demulcent drinks ; olive oil, in large quantities, produces a soap. 
Milk may be copiously administered. Stomach-pump should not 
be used. 

Potassium Bitartrate (cream of tartar). — Same treatment as for 
the nitrate. Dilute solution of potassium bicarbonate reduces 
bitartrate to harmless neutral tartrate. 

Potassium Cyanide. — Weak solution of ferrous sulphate converts it 
into Prussian blue ; subsequent treatment similar to that for 
hydrocyanic acid. 



444 TREATMENT OF POISONS. 

Potassium Nitrate. — No direct antidote; stomach-pump; free 
vomiting, and copious mucilaginous drinks : stimulants, opium, 
and coffee, if great depression exist. 

Prussic acid. — See Hydrocyanic Acid. 

Silver, The Salts of. — Albumen, milk. If nitrate, give the chlo- 
ride of sodium, followed by emetics. 

Soda, and its Preparations. — Same treatment as for potassa 
poisoning. 

Stramonium. — Same treatment as for poisoning by belladonna. 
Morphia should be administered hypodermically. 

Strychnia. — Bromide of potassium, in very large doses. Hydrate 
of chloral, nitrite of amyl, and atropia have also heen recom- 
mended. Prompt emesis by stomach-pump, or mustard and 
warm water, or mixture of ipecacuana and zinc sulphate. Inhala- 
tion of chloroform, continuously employed, may relieve tetanic 
rigidity. 

Sulphuric Acid. — Same treatment as for poisoning by muriatic 
acid. Solution of sodium carbonate in milk and water. Stomach- 
pump must not be used. 

Sulphate op Indigo. — Calcined magnesia and milk, or fluid mag- 
nesia. 

Tartaric Acid. — Same treatment as for poisoning by citric acid or 
oxalic acid. 

Tartar Emetic — See Antimony. 

Tobacco. — Stomach-pump or emetics ; whiskey, strychnia, stimu- 
lating injections per anum, containing turpentine, or ammonia. 

Veratrum. — 'Rapid emesis, stimulants, with laudanum or some 
other opiate. Tannin has been proposed as an antidote. 

Zinc Chloride. — Albumen given liberally. Free emesis, copious 
warm mucilaginous drinks, or stomach pump. 

Zinc Sulphate. — Tepid water with milk and albumen ; infusions 
containing tannic acid. Stomach-pump. Laudanum and starch 
enemata. 

There are a number of so-called vegetable irritants, such as 
aloes, scammony, and jalap, which may give rise to toxical 
symptoms. Their effects should be treated on general prin- 
ciples, such as the employment of emetics, diluents, castor 
oil, opium, and fomentations. The same remarks apply also 
to the various articles of diet, such as meat, fish, lobsters, or 
fruits, which occasionally produce similar results. Irritant 
gases, as chlorine, nitrous acid, or sulphurous acid vapor, 
etc., may act as poisons, and their effects should be treated 
by removal of the patient from the causes, cold affusion, and 
by antidotes as directed. The numerous poisonous fungi, 
which may be taken into the stomach, may also produce 
symptoms, and require treatment on general principles. 



TREATMENT OF POISONING. 



445 



Bites of venomous reptiles require special treatment ; the 
wound may be sucked with impunity, provided there be no 
abrasion upon the lips or tongue. The limb above the point 
having a ligature placed around it, or compressed, the part 
involved may be excised or cauterized with the hot iron or 
nitric acid. The intravenous injection of ammonia has also 
been advised. Stimulants, as ammonia or brandy, should 
also be freely given. The local treatment here detailed 
would also be applicable to bites of rabid animals. 

The following table, from Taylor " On Poisons," gives a 
comprehensive review of the most approved antidotes for the 
several principal poisons noticed in the foregoing pages, 
which should be committed to memory — 



NON-METALLIC POISONS. 



Mineral 
Acids 

Vegetable 

Acids 
and their 
Alkaline 

Salts 

Alkalies 



Poisons. 

f Sulphuric 

Nitric 
j Muriatic 
[ Nitro-muriatic 
f Oxalic 
j Tartaric 

] Potassium Binoxa- 
late 

Potassium. Bitar- 
trate 

{Potassa, soda, am- 
monia, and their 
carbonates 



Antidotes. 

Magnesia mixed with water or 

milk ; calcium carbonate ; 

compound chalk powder ; 

soda; potassa; the fixed oils. 
Calcium carbonate (chalk or 

whiting) . 

Calcium carbonate. Calcium 

sulphate, and water. 
Sodium carbonate in solution. 



Vinegar, lemon-juice, 
acid, or oil. 



citric 



METALLIC POISONS. 



Arsenic 1 and soluble arsenites. 

Corrosive sublimate, and salts of 
mercury. 



f Hydrated peroxide of iron ; hy- 
J drated magnesia ; solution of 
j dialyzed iron. 
^ Mixture of oil and lime-water. 
( Albumen, gluten, or Hour, diffused 
} in water or milk. 



1 In some cases of arsenical poisoning the force of the poison 
seems to he principally directed to the nervous system, and no 
marked morbid appearances can be found in the stomach and intes- 
tines after death (Christison), although as a rule it causes gastric 
symptoms and inflammation of the stomach and bowels, no matter 
by what channel it is introduced into the system. The local 
changes, however, might be less marked where it is received by a 
distant channel, as when administered in an enema or vaginal in- 
jection, as stated on page 150. 
38 



446 



TREATMENT OF POISONING. 



Poisons. 
Baryta and its soluble salts. 

Barium carbonate. 

Alum. 

Soluble salts of lead. 

Lead carbonate. 

Soluble salts of copper. 

Tartar emetic. 

Antimony chloride. 
Salts of tin. 

Zinc sulphate, or acetate. 

Ferrous sulphate. 
Silver nitrate. 



Antidotes 

i Sodium, potassium, magnesium, 
{ or calcium sulphate. 
$ Mixture of magnesium sulphate 
I and vinegar. 

Sodium or ammonium carbonate. 
( The alkaline, or soluble earthy 
( sulphates. 

Magnesium sulphate and vinegar. 
( Albumen, gluten, flour diffused in 
( water ; milk. 

i Decoctions and tinctures contain- 
< ing tannic acid. 
^Magnesia. 

Sodium carbonate ; magnesia. 
( Milk ; sodium carbonate ; mag- 
( nesia. 

( Milk ; sodium carbonate ; mag- 
( nesia. 

Sodium or ammonium carbonate. 

Sodium chloride, and emetics. 



NARCOTIC POISONS. 



f Emetics; stomach-pump, cold af- 



Opium ; hyoscyamus. 



Prussic acid. 



fusion. Strong decoction of cof- 
fee ; electro-magnetism ; tannic 

[ acid. 

i Ammonia ; chlorine ; cold affu- 

< sion ; iron and potassium car- 

^ bonate (see p. 90). 



MODES OF DISTINGUISHING SOME OF THE VEGETABLE 
ALKALOIDS, WHEN IN POWDER. 

Treat the powder with nitric acid ; this is colored red by 
Brucia, Delphinia, Morphia, and by the Strychnia of com- 
merce, but not the pure. If the reddened acid become 
violet on the addition of protochloride of tin, it is Brucia; 
if it become black and carbonaceous, it is Delphinia. If the 
powder be fusible without decomposition, and decompose 
iodic acid, it is Morphia : if it be not fusible without decom- 
position, and do not decompose iodic acid, it is Strychnia. 
If the powder strike a green with nitric acid, it is Solania ; if 
insoluble in ether, and do not redden nitric acid, it is Emetia ; 
if soluble in ether, and do not redden nitric acid, but should 
melt and volatilize with heat, it is Atropia; if thus affected 
by ether or nitric acid, but do not volatilize, it is Veratria. 
(Griffith.) 



QUESTIONS. 

In submitting a series of questions to the consideration of 
the student, I have endeavored to place various suggestive 
points before him in interrogative form, and to approach the 
border line between practical medicine and therapeutics by 
introducing a few short illustrative cases. The principle 
seems to me worthy of further development, and a systematic 
collection of typical diseases, with variations and exceptions 
and bed-side gleanings, might lead the way profitably up to 
those diffuse collections of symptoms which are occasionally 
rolled into concrete form by our examining boards. 

It would not be difficult to expand my collection of queries 
to an almost unlimited extent ; but the conscientious attempt 
to answer those already constructed will at all events encour- 
age the young reader to think for himself, and to emanci- 
pate his mind and memory from the enervating trammels of 
the more grinding forms of manuals. 



1. A child is under treatment for whooping-cough, and 
the mother states that after each dose of his medicine his 
face flushes, and he complains of his throat being very dry. 
What drug is most likely to produce these symptoms ? 

2. Mention the different remedies to be employed in the 
various stages of syphilis. 

3. A case of acute eczema presents itself for treatment; 
there is much moist exudation, with smarting and tingling 
and almost erysipelatous redness. It is proposed to give 
arsenic. Would this meet with your approval, and what 
would be your line of practice ? 

4. A patient comes to you in great alarm, thinking that 
he is paralyzed, his legs feeling weak and heavy, and his 
gait becoming staggering. At the same time you observe 
a few pimples of acne on his forehead, and you learn that he 
has lately been suffering from sleeplessness. To what would 
your suspicions point as the cause of his symptoms ? 



]$. Tinct. hyoscyarni 


f5?s; 


or 


2 


Gm. 


Liq. potassae 


Rxx; 


(< 


1 


30 " 


Mucilaginis 


'3i; 


c< 


4 


(« 


Gentianae iufusi 


fii; 


(< 


32 


<< 


Ter die. 








- 



448 QUESTIONS. 

5. Give directions for disinfecting a room which has been 
occupied by scarlatinous patients. 

6. Mention a drug which seems to have a specific influ- 
ence over the poison of erysipelas, and write a prescription, 
with full directions for its use. 

7. Write a prescription for an effervescing draught con- 
taining carbonate of ammonia. 

8. Point out the error in the following prescription : — 



M. 



9. You are called to a very severe case of delirium tre- 
mens. It seems inadvisable to give opium, and chloral has 
already failed. What course, therefore, would you pursue ? 

10. Mention the antidotes for prussic acid, strychnia, 
arsenic, and opium, with the general line of treatment to 
be pursued in a case of poisoning by each of these substances. 

11. You are called to the following case. A middle-aged 
man has been known to suffer from heart-disease, and on 
applying your ear to his chest you hear a well-marked 
mitral-regurgitant bruit. His face is pale, with a tendency 
to lividity, his feet are beginning to swell, his pulse is weak 
and irregular, and does not accurately correspond to the beat 
of the heart, many of whose pulsations are not transmitted 
to the wrist. There are great anxiety and breathlessness, 
and ordinary stimulants have given only temporary relief. 
State your line of practice in such a case, and more espe- 
cially the drug from which you would expect to derive 
speedy benefit. 

12. Mention the various drugs which have been of service 
in tetanus, with your opinion of their relative efficiency, and 
give the dose of each. 

13. Explain the action of the principal anaesthetic agents, 
and state which you consider to be most worthy of con- 
fidence. 

14. Mention the remedies which act on the pupil, and 
divide them into those which act locally and constitutionally. 

15. A patient consults you with the following symptoms : 
Excessive drowsiness whilst he is sitting up, but whenever 
he lies down his mind seems to become much more active 



QUESTIONS. 449 

and he cannot sleep. He looks pale and weak, and his 
pulse, although fairly full, is readily compressible. He has 
been advised to take chloral at bed-time, which seems to 
make him more wakeful. What would be your line of 
treatment ? 

16. Mention some good remedies for chronic winter cough. 

17. What are the best remedies for prurigo senilis? 

18. Are there any means of preventing or removing the 
bromide rash ? 

19. Mention those drugs which have been proved to pos- 
sess a real disinfecting power, and state the difference be- 
tween a disinfectant and an antiseptic. 

20. Write a prescription for salicylic acid, and state what 
advantages, if any, the soda salt possesses. 

21. Give the main points of resemblance and of dissimi- 
larity between salicylic acid and quinine. 

22. Describe the various ways in which mercury may be 
introduced into the system, with their relative advantages 
and inconveniences. 

23. You are asked to see a patient suffering from most 
violent nocturnal headache and tenderness over the forehead. 
On inquiry into the history of the case, you find that he has 
had syphilis, and on further examination you find some large 
serpiginous sores on the lip. It has been proposed to give 
him mercury. Would this be judicious ? 

24. A patient, aet. 30, is brought into your consulting- 
room, suffering from hemiplegia, which came on suddenly, 
without loss of consciousness, about three months ago. His 
aspect is very cachectic, there is some external strabismus, 
and although his sight is apparently good, the ophthalmo- 
scope detects double optic neuritis. Previous to the attack 
he complained of fixed pain in the head. Heart and kidneys 
sound. What is the probable cause of this man's symptoms, 
and his chances of recovery under appropriate treatment ? 
Describe that treatment. 

25. Mention the principal causes of vomiting, with the 
appropriate remedies. 

26. We are very anxious to prescribe quinine for a patient, 
but find that it cannot be borne, on account of headache and 
ringing in the ears. Is there any way of preventing this ? 

27. Write a soothing cough-medicine for a case of phthisis, 
and include chlorate of potash and morphia. Dose, one tea- 
spoonful. 

38* 



450 QUESTIONS. 

28. State the general treatment of a case of chorea, with 
the principal drugs which have been found useful, and give 
your opinion of their respective merits. 

29. What are the indications by which we know that 
conium, arsenic, and strychnia are beginning to produce 
their physiological effects ? 

30. Mention those drugs which are most readily absorbed 
through the unbroken cuticle. 

31. Enumerate the principal cholagogue cathartics. 

32. State the principal differences between the action of 
opium and morphia. 

33. You are called to see a case of severe sprained ankle, 
and hear that a friend is about to apply tincture of arnica. 
On inquiry you find that this remedy has never been used 
to this patient before. Would you sanction the treatment ? 

34. Enumerate those drugs which stimulate, and those 
which depress, the action of the heart. 

35. State which drugs are most worthy of confidence in 
cases of neuralgia of the fifth nerve. 

36. A patient presents himself with the following symp- 
toms : Constipation and violent colicky pain in the belly, 
some loss of power in the extensor muscles of the arms, a 
bluish line along the margin of the gums, and anaemia. What 
is the cause of, and the proper treatment for, his complaint ; 
and w 7 hat prophylactic means would you recommend him to 
adopt ? 

37. Mention the various means of lowering the bodily 
temperature in health and disease, and explain their action, 
more especially enumerating those remedies which act only 
in conditions of pyrexia. 

38. You have been attending a case of rheumatic fever, 
and all has gone on well until you are told one morning that 
the patient has had a disturbed night, has been restless and 
delirious, but that, at the same time, the pain in the joints 
has subsided. You find him looking dull, confused, and only 
partially conscious. The temperature registers 105°, and in 
another hour has gone up to 106°. What treatment would 
you advise ? 

39. State the principal dangers to be anticipated in chloro- 
form administration, with their appropriate remedies. 

40. Mention the unpleasant effects which sometimes follow 
the use of quinine. 



QUESTIONS. 451 

41. What do yon mean by "accumulation" in therapeu- 
tics? 

42. A young married woman comes to ask relief for 
troublesome sickness and vomiting, recurring at intervals 
throughout the day, but always worse on first rising in the 
morning. What would you advise in the way of treatment, 
and how can you explain her symptoms ? 

43. Write a prescription for an alkaline lotion in a case 
of acute eczema. 

44. Mention the best narcotics to be used under the fol- 
lowing circumstances : — 

1. Sleeplessness from overwork or worry. 

2. Delirium tremens. 

3. The fierce delirium of typhus. * 

4. Acute mania. 

45. Write a prescription for iron in combination with 
potassium iodide and a vegetable bitter. 

46. Mention the various drugs which produce eruptions 
on the skin, and describe the forms of eruption produced. 

47. Mention the drugs which impart a peculiar color to 
the urine, with the varieties of tint produced. 

48. Contrast the paralyzing effects of conium, Calabar 
bean, and veratria. 

49. State the physiological phenomena which may follow 
comparatively small doses of quinine, potassium iodide, potas- 
sium bromide, chloral, and mercury. 

50. State what you mean by a refrigerant. 

51. You are called to see a patient in an advanced stage 
of phthisis, in whom the night-sweats are causing serious 
exhaustion. All astringent remedies having failed, what 
drug would you recommend to be employed, and in what 
doses ? 

52. A patient is seized with acute tonsillitis, and it is of 
great importance that he should recover his voice in a short 
time. Mention a drug which you might prescribe with good 
hopes of speedy benefit. 

53. An elderly man is attacked with acute bronchitis, the 
cough and dyspnoea being urgent, and the sputa brought up 
with difficulty. The blood is beginning to be imperfectly 
aerated, the skin looking dusky and the lips blue, and al- 
though he is occasionally drowsy by day, he can obtain no 
sleep in the night from the constant and irritating cough. 
His family are much distressed at this insomnia, and having 



452 QUESTIONS. 

persuaded the doctor to give him something to make him 
sleep, a full dose of opium is ordered. State tlie probable 
result of this line of practice. 

54. You are summoned to see a case of ague. The patient 
cannot take bark or quinine in any form. What drug would 
you recommend in their place ? 

55. A case of diarrhoea presents itself, characterized by 
furred tongue, cramping pains in the abdomen, sickness and 
tenesmus, with the expulsion of rather scanty but thin and 
frequent evacuations. It is proposed to arrest this by means 
of astringents. State whether this treatment would meet 
with your approval, and what your own plan would be. 

56. You are called to a bad case of haemoptysis — all the 
usual astringents and styptics have failed. What drug would 
you recommend, and how would you administer it ? 

57. State the best remedies for nocturnal incontinence of 
urine. 

58. Mention the principal medicines used for hypodermic 
injection, and the mode of performing the operation. 

59. Give instances of toleration of drugs. 

60. Describe your treatment of purpura haemorrhagica. 

61. State the rules which would guide you in prescribing 
acids and alkalies in dyspepsia. 

62. Write a prescription for a lotion containing hydro- 
cyanic acid. 

63. Mention the uncomfortable effects sometimes resulting 
from the subcutaneous injection of morphia, and suggest 
some means for obviating them. 

64. Have any bad effects been recorded as following the 
subcutaneous injection of quinine ? 

65. You are called to a case of diarrhoea in which the 
motions are largely composed of blood and mucus, and much 
pain and tenesmus follow each evacuation of the bowels. 
Ordinary astringents having failed, what special drug would 
you advise ? 

66. Give proof of the rapid absorption of drugs into the 
blood. 

67. Give instances of the different, and oven opposite, 
effects of drugs in large and in small doses. 

68. Mention drugs which check, and others which pro- 
mote, the salivary secretion. 

69. Mention appropriate remedies for migraine. 



QUESTIONS. 453 

70. Mention those drugs which depress, and those which 
excite, the activity of the spinal cord. 

71. Which preparation of conium is most deserving of 
confidence, and in what dose should it be given ? 

72. Which diuretics act more especially by influencing the 
renal circulation ? 

73. Mention those drugs which destroy, and those which 
aid in the construction of, the red corpuscles of the blood. 

74. Have any drugs the power of raising the temperature 
of the body? 

75. Enumerate the secondary action of emetics, and ex- 
plain them physiologically. 

76. A little girl, of two years old, is brought to you, the 
mother stating that she is tender to the touch, perspires much 
about the head at night, sleeping restlessly, and throwing off 
the clothes. On inquiry, you find that the dentition was late, 
and tiiat she has only been weaned five months. The head 
is large and square, the anterior fontanelle open, and there 
are beadings at the juncture of the ribs with their cartilages. 
What is the disease, and what its appropriate treatment ? 

77. Mention the principal drawbacks attending the sub- 
cutaneous injection of other drugs than morphia. 



LWEIGHTS AND MEASURES. 



APOTHECARIES' WEIGHTS AND MEASURES. 

One Pound, lb = 12 Ounces = 5,760 Grains. 

One Ounce, % = 8 Drachms = 480 Grains. 

One Drachm, 5 = 3 Scruples = 60 Grains. 

One Scruple, § = 20 Grains. 

One Grain, gr. = 1 Grain. 

One Gallon, C = 8 Pints = 61,440 Minims. 

One Pint, O = 16 Fluidounces = 7,680 Minims. 

One Fluidounce, f§ = 8 Fluidrachms= 480 Minims. 

One Flaidrachm, f^ = 60 Minims. 

One Minim, T\ = 1 Minim. 

Note. — In prescribing, the troyounce, drachm, and grain, or the fluidounce, 
drachm, and minim, only should be use.l. 

RELATION OF WEIGHTS AND MEASURES OF THE U. S. 
PHARMACOPOEIA TO EACH OTHER. 

In distilled water at the temperature of 60°. 

One Pound = 0.7900031 Pint = 6,067.2238 Minims. 

One Ounce = 1.0533376 Fluidounces = 505.6019 Minims. 

One Drachm = 1.0533376 Fluidrachms = 63.2002 Minims. 

One Scruple , = 21.0667 Minims. 

One Grain = 1.0533 Minims. 



One Gallon = 

One Pint = 

One Fluidounce = 
One Fluidrachm= 
One Minim 



10.1265427 Pounds 
1.2358178 Pounds 
9493633 Ounce 
0.9493633 Drachm 



= 58,328.8862 Grains. 

= 7,291.1107 Grains. 

= 455.6944 Grains. 

= 56.9618 Grains. 

= 0.9493 Grain, 



RELATION OF MEASURES OF THE U. S. PHARMACOPOEIA 
TO CUBIC MEASURE. 



One Gallon 
One Pint 
One Fluidounce 
One Fluidrachm 
One Minim 



231. Cubic Inches. 

28.875 Cubic Inches. 

1.80468 Cubic Inches. 

0.22558 Cubic Inch. 

0.00375 Cubic Inch. 



WEIGHTS AND MEASURES. 



455 



WEIGHTS AND MEASURES OF THE METRIC SYSTEM. 



MEASURES OF LENGTH. 



One Myriametre 
One Kilometre 
One Hectometre 
One Decametre 
One METRE 



= 10,000 Metres. 
= 1,000 Metres. 
300 Metres. 
= 10 Metres. 

= the ten-millionth part of a quarter of the 

meridian of the earth. 
= the tenth part of one Metre, or 0.1 Metre. 
= the hundredth part of one Metre, or 0.01 

Metre. 
One Millimetre = the thousandth part of one Metre, or 0.001 

Metre. 

(A metre is equal to 39.37 inches ; a centimetre to ^ of an inch ; 
and a millimetre to -£■% of an inch) . 



One Decimetre 
One Centimetre 



WEIGHTS. 

10,000 Grammes. 

1,000 Grammes. 

100 Grammes. 

10 Grammes. 

the weight of a cubic centimetre of water at 

40 C. 

the tenth part of one Gramme, or 0.1 Gramme, 
the hundredth part of one Gramme, or 0.01 
Gramme. 
One Milligramme = the thousandth part of one Gramme, or 0.001 

Gramme. 



One Myriagramme 
One Kilogramme 
One Hectogramme 
One Decagramme 
One GRAMME 

One Decigramme 
One Centigramme 



MEASURES OF CAPACITY. 

One Myrialitre = 10 cubic Metres, or the measure of 10 Milliers 

of Water. 
One Kilolitre = 1 cubic Metre, or the measure of 1 Millier 

of Water. 
One Hectolitre = 100 cubic Decimetres, or the measure of 1 

Quintal of Water. v 

One Decalitre = 10 cubic Decimetres, or the measure of 1 

Myriagramme of Water. 
One LITRE = 1 cubic Decimetre, or the measure of 1 

Kilogramme of Water. 
One Decilitre = 100 cubic Centimetres, or the measure of 1 

Hectogramme of Water. 
One Centilitre = 10 cubic Centimetres, or the measure of 1 

Decigramme of Water. 
One Millilitre = 1 cubic .Centimetre, or the measure of 1 

Gramme of Water. 



456 



WEIGHTS AND MEASURES. 



RELATION OF WEIGHTS OF THE U. S. PHARMACOPOEIA 
TO METRICAL WEIGHTS. 



Fractions of a 


grain in 


Grains in 


eq 


nivalent 


& 


rammes. 


metrica 


weights. 


Grain 


G 


rammes. 


Grains. 


Grammes. 


l 

6¥ 


=3 


0010 


1 = 


0648 


1 
60 

1 
50 

1 
48 


E 


0011 
0013 
0014 


2 = 

4 = 

5 = 




1295 
1943 
2591 
3239 


1 
4 


= 


0016^ 


6 = 




3887 


1 
36 

1 
30 

1 
25 


= 


0018 
0022 
0026 


8 = 
10 = 




4535 
5183 
5831 
6479 


1 
2T 


— 


0027 


12 = 




7775 


1 

20 

1 
1 6 

1 
1 5 


as 


0032 
0040 
0043 


15 = 

16 = 
20 = 
24 = 


1 
1 

1 


9718 

036 

295 

555 


_j_ 


— 


0054 


25 = 


1 


619 


1 2 

1 
1 

1 

8 

1 

6 


= 


0065 

00S1 
0108 


30 == 

40 = 
50 = 
60 = 


1 

2 
3 
3 


943 

591 
239 

887 


1 
5 


= 


0130 






1 
4 


= 


0162 






1 
3 


= 


0236 






1 

2 


= 


0324 









Drachms, ounces, and 

pouuds in equivalent 

metrical weights. 



Drachms. Grammes. 



= 3 

= 11 

= 15 

= 19 

= 23 

= 27 



Ounces. 

1 = 

2 = 

3 = 

4 = 

5 = 

6 = 

7 = 

8 = 

9 = 

10 = 

11 = 



31 

62 

93 

124 

155 

186 
217 
248 
279 
311 
342 



887 

775 

66 

55 

43 

32 

21 



103 

206 
309 
41 
51 

61 

72 
82 
92 
03 
13 



Pounds. 

1 =s 373124 

2 = 74648 

3 = 1119 72 



WEIGHTS AND MEASURES. 



457 



RELATION OF METRICAL WEIGHTS TO WEIGHTS OF THE 
U. S. PHARMACOPOEIA. 



Metrical 


Exact 


Approximate 


Met 


•ica.l 


Exact 


Approximate 


weights. 


equivalents 
ia grains. 


equivalents 
in grains. 


weights. 


equivalents 
in grains. 


equivalents 
Troy weight. 


Millig 


rammes. 




Grammes 






1 


= 


.0154 


l 
65 


1 


= 


15.434 


£r. xv. 


2 


= 


.0308 


1 
3 2 


2 


= 


30.868 


5ss. 


3 


= 


.0463 


1 

2" 2 


3 


= 


46.302 


9u- 


4 


= 


.0617 


1 
1 6 


4 


= 


61.736 


5i- 


5 


= 


.0771 


1 
1 3 


5 


= 


77.170 


Biv. 


6 


= 


.0926 


1 
IT 


6 


= 


92.604 


5>ss. 


7 


= 


.1080 


1 
9 


7 


= 


108.038 


Bvss. 


8 


= 


.1234 


1 

8 


8 


= 


123.472 


5i.i- 


9 


= 


.1389 


1 

7 


9 


= 


138.906 


9^ij. 


Centigrammes. 




Deca 


grammes." 




1 


= 


.1543 


1 
6 


1 


= 


154.340 


3iiss. 


2 


= 


.3086 


1 
3 


2 


= 


308.680 


5v- 


3 


= 


.4630 


6 
1 3 


3 


= 


463.020 


.^viiss. 


4 


= 


.6373 


7 
1 l 


4 


= 


• 617.360 


Hx. 


5 


= 


.7717 


3 

4 


5 


= 


771.701 


Sxiij. 


6 


= 


.9260 


9 
1 9 


6 


'= 


926 041 


5xv. 


7 


= 


1.0803 


1 


7 


= 


1,080.381 


PJxviij. 


8 


= 


1.2347 


4 


8 


= 


1,234.721 


5xx. 


9 


= 


1.3890 


H 


9 


= 


1.389.062 


3xxiij. 


Decigrammes. 




Hectc 


grammes. 




1 


= 


1.543 


il 


1 


= 


1,543.402 


§iij B^ r - 


2 


= 


3.086 


3 


2 


= 


3,086.804 


|vj ffiij. 


3 


= 


4 630 


H 


3 


= 


4,630.206 


%ix %v. 


4 


= 


6.173 


6 


4 


= 


6,173.609 


fej 5Vij. 


5 


= 


7.717 


7i 

' 2 


5 


= 


7,717.011 


ft j §iv. 


6 


= 


9.260 


9 


6 


= 


9,260.413 


tt>j §vij. 


7 


= 


10.803 


11 


7 


= 


10,803.816 


»>j o x 3iv. 


8 


= 


12.347 


121 


8 


= 


12,347.218 


Ibij §i 3v. 


9 


= 


13.890 


14 


9 


= 


13,890.620 


aij § v r 










Kilog 


rarame, 












1 


= 


15,434.023 


Ibij ^viij. 










Myriagramme. 












1 


=154,340.23 


f ft> xxvi. 
j§ix 3iv. 



39 



458 WEIGHTS AND MEASURES. 

RELATION OF MEASURES OF THE U.S. PHARMACOPOEIA 
TO METRICAL MEASURES. 

One Gallon = 3.785 Litres. 

One Pint = 4.732 Decilitres. 

One Fluidounce = 2.957 Centilitres. 

One Fluidrachm = 3.697 Millilitres. 

One Minim = 0.061 Milliiitre. 

RELATION OF METRICAL MEASURES TO MEASURES OF 
' THE U.S. PHARMACOPC3IA. 

One Myrialitre = 2641.9 Gallons. 

One Kilolitre = 264.19 " 

One Hectolitre = 26.419 " 

One Decalitre = 2.641 " 

One Litre = 2.113 Pints. 

One Decilitre = 3.381 Fluidonnces. 

One Centilitre = 2.705 Flnidrachms. 

One Milliiitre = 16.231 Minims. 



THE METRIC SYSTEM IN MEDICINE. 



OLD STYLE. METRIC. 



V\ j or gr. j equals ..... 

f3Jor5J " 4 

fgj or ij 32 



06 Gm. 



The decimal line instead of points makes errors impossible. 

As .06 (Drug) is less than a grain, while 4. and 32. (Vehicle) 
are more than the drachm and ounce, there is no danger of giving 
too large doses of strong drugs. 

C. C. (cubic centimetres) used for Gms. (Grammes) causes an 
error of 5 per cent, (excess). 

A teaspoonful is usually 5 Gms. ; a tablespoonful 20 Gms.] 



THERAPEUTIC SUGGESTIONS; 

OR, 

INDEX OF DISEASES. 



ABSCESSES 
belladonna, 160 

cantharidal collodion, 268 

carbolic acid, 85 

cod-liver oil, 317 

flaxseed poultice, 300 

ice, 144 

iodine, 288 

sulphide of lime, 175 

yeast, 251 
Acne faciei 

sulphur, 398 
Acute mania 

belladonna, 160 

bromide of potassium, 362 

chloral, 195 

conium, 227 

dulcamara. 243 

hyoscyamus, 285 

Indian hemp, 180 

opium, 328 
After-pains (see Labor) 
Ague 

apiol, 434 

arsenic, 152 

dogwood, 233 

eucalyptus, 424 

nectandra, 313 

quinia, 216 

salicin, 434 
Ague-cake (see Spleen, enlarged) 
Albuminuria 

arsenic, 154 

(See also Bright's disease) 
Alcoholism 

stopping supplies, 116 

tincture of capsicum, 185 
Amaurosis 

strychnia, 314 



Amenorrhea 

aloes, 124 

apiol, 434 

cantharides, 184 

catnep, 190 

cimicifuga, 210 

cotton-root bark, 267 

ergot, 247 

hedeoma, 270 

hellebore, 271 

hiera picra, 179 

iron, 254 

marjoram, 336 

myrrh, 312 

pennyroyal, 270 

rue, 375 

savin, 377 

turpentine, 405 
Anemia 

cod-liver oil, 318 

iron, 254 

phosphorus, 338 

solution of dialyzed iron, 431 

(See also Leucocythemia) 
Aneurism 

ergotine injections, 246 

iodide of potassium, 364 
Angina (see Sore throat) 
Angina pectoris 

opium, 330 

hypodermic injection of mor- 
phia, 334 

nitrite of amyl, 418 

nitro-glycerin, 432 
Animal-poisoning (see Poison- 
ing) 
Aphthous sore-mouth 

borax, 392 

chlorate of potassium, 353 



460 



INDEX OF DISEASES. 



Aphthous sore mouth — 

sulphite of sodium, 398 

sulphurous acid, 102 
Apoplexy 

croton oil, 324 
Arsenical poisoning (see Poison- 
ing) 
Ascarides (see Worms) 
Ascites (see Dropsy) 
Asthma 

aether, 112 

antimony, 138 

arsenic, 152 

atropia, 164 

belladonna, 164, 167 

chloral, 194 

chloroform, 203 

cod-liver oil, 318 

ether, 112 

eucalyptus globulus, 424 

ipecacuanha, 290 

lobelia, 303 

nitre papers, 358 

nitrite of amyl, 419 

nitro -glycerin, 432 

opium, 330 

pepsin, 434 

pilocarpin, 428 

stramonium, 397 

tobacco-smoking, 402 

turpentine stupes, 405 
Atheroma 

digitalis, 240 



BILIARY COLIC (see Gall- 
stones) 
Biliousness 

acids, 46 

blue pill, 278 

nitro-muriatic acid, 98 

ipecacuanha, 292 

taraxacum, 404 

(See Hepatic disorders) 
Bites 

caustic potassa, 354 

excision, etc., 445 

nitrate of silver, 147 

(See also Poisoning) 
Bladder affections (see Cys- 
titis) 
Boils (see Abscesses) 



Bowel affections (see Diarrhoea 

and Constipation) 
Brain-affectioss 

blisters, 183 

bromide of potassium, 360 

croton oil, 324 

iodide of potassium, 364 

(See also Meningitis and Syph- 
ilis) 
Brain-soften ing 

phosphorus, 338 
Bright's disease 

alkalies, 357 

compound jalap powder, 294 

cream of tartar, 359 

diaphoretics, 61 

ergot, 246 

gallic acid, 260 

iron, 255 

jaborandi, 426 

pilocarpin, 428 

pipsissewa, 192 

potash salts, 357 

scoparius, 386 

water, 145 
Bromide-acne 

arsenic, 17 
Bronchitis 

aether, 112 

ammonia, 130, 131, 133 

ammoniac, 127 

antimony, 138 

arsenic, 152 

assafcetida, 156 

balsam of Peru, 158 

balsam of tolu, 158 

benzoin, 168 

carbolic acid, 88 

carbolic acid inhalations, 88 

chloride of ammonium, 130 

cod-liver oil, 317 

copaiba, 229 

corrosive sublimate, 277 

digitalis, 241 

eucalyptus, 424 

garlic, 122 

iodide of posassium, 366 

ipecacuanha, 290 

linseed tea, 301 

lobelia, 303 

mustard plasters, 391 

myrrh, 311 



INDEX OF DISEASES. 



461 



Bronchitis — 

oil of amber, 323 

opium, 330 

phosphoric acid, 100 

seneka, 388 

squill, 385 

steam, 144 

sulphur, 399 

tar, 346 

tartar emetic, 25 

turpentine, 405 

turpentine stupes, 405 

wild-cherry bark, 369 
Bronchocele (see Goitre) 
Broncho-pneumonia 

antimony, 138 

(See Bronchitis and Pneumo- 
nia) 
Bubo 

ice, 144 

(See also Abscesses) 
Bursts 

carbolic acid, 85 

carbonate of lead, 348 

carbonate of soda, 393 

carron oil, 174, 301 

collodion, 268 

cotton, 267 

warm-bath, 144 



CALCULUS (phosphatic) 
nitric acid injections, 98 

potassa, 357 

(See also Gravel) 
Caxcer 

acetic acid, 83 

arsenic, 150 

blood-root, 379 

chloride of zinc, 414 

chloroform, 205 

citric acid, 89 

iodoform, 289 

opium, 329 
Cancrdm oris 

nitric acid, 97 
Cardiac disease (see Heart dis- 
ease) 
Cardiac dropsy (see Dropsy) 
Cardiac palpitation (see Heart 
disease) 



Caries 

cod-liver oil, 319 

sulphuric acid, 101 
Catarrh (chronic) 

assafcetida, 122 

ipecacuanha, 291 

(See also Bronchitis and Co- 
ry z a) 
Cerebral disorders (see Brain 

affections) 
Chafing (see Excoriation) 
Chancre (see Syphilis) 
Chapped hands 

collodion, 268 

glycerine, 265 
Chill (see Ague) 

alcohol, 118 
Chilblains 

tr. iodine, 288 
Chills and fever (see Ague) 
Chloasma 

sulphurous acid, 102 

(see also Skin diseases) 
Chlorosis 

iron. 254 

solution of dialyzed iron, 431 

(See also Anseinia) 
Cholera 

cajujDut oil, 173 

camphor, 178 

cold affusions, 143 

hypodermic injections of mor- 
phia, 334 

nitrite of amyl, 419 
Cholera infantum (see Diar- 
rhoea) 
Cholera morbus 

acetate of lead, 350 

opium, 331 

sulphuric acid, 102 

(See also Diarrhoea) 
Chordee 

camphor, 178 
Chorea 

aether, 111 

arsenic, 150 

belladonna, 166 

bromide of iron, 253 

bromide of potassium, 361 

chloral, 194 

cimicifuga, 210 



39* 



462 



INDEX OF DISEASES. 



Chorea — 

chloroform, 205 

conium, 226 

cold affusion, 144 

copper, 236 

ether-spray, 111 

iron, 253 

oxide of zinc, 414 • 

physostiguia, 342 

manganesium sulphate, 306 

sulphate of zinc, 414 
Chronic mania 

cimicifuga, 210 

cod-liver oil, 317 

ergot, 245 

hemlock, 227 
Chronic nephritis (see Bright's 

disease) 
Cinchonism 

hydrobromic acid, 21 
Colds (see Coryza) 
Colic 

assafcetida, 156 

belladonna, 164 

cajuput oil, 173 

catnep, 190 

chloroform, 205 

cloves, 188 

ether, 110 

fennel tea, 258 

flaxseed poultices, 300 

ginger, 415 

oleum monardae, 310 

mustard, 391 

opium, 329 

pennyroyal, 270 

warm bath, 144 
Colica pictonum (see Painter's 

colic) 
Color-blindness 

santonin, 380 
Condylomata 

acid nitrate of mercury, 275 

black-wash, 276 

carbolic acid, 85 

chromic acid, 88 

(See also Syphilis) 
Congestion of brain 

bromide of potassium, 360 

compound jalap powder, 294 

croton oil, 324 

elaterium, 244 



Congestion of spinal cord 

belladonna, 163 

ergot, 245 
Conjunctivitis 

alum, 126 

lard, 110 

silver nitrate, 147 

zinc sulphate, 414 
Constipation 

aloes, 124 

alum, 126 

assafcetida, 156 

belladonna, 164 

castor oil, 321 

colocynth, 225 

confection of senna, 189 

croton oil, 324 

elaterium, 244 

gamboge, 260 

jalap, 295 

juglans, 295 

leptandra, 298 

magnesii sulph. 102 

mix vomica, 313 

podophyllum, 351 

sambucus, 378 

senna, 389 

strychnia, 313 

sulphur, 399 

taraxacum, 403 
Consumption (see Phthisis) 
Contusions 

vinegar, 82 
Convulsions, epileptic (see Epi- 
lepsy) 
Convulsions, hysterical (see 

Hysteria) 
Convulsions, infantile 

assafcetida, 156 

bromide of potassium, 360 

chloral, 195 

chloroform, 205 

conia, 227 

ether, 110 

garlic, 122 

hemlock, 225 

mustard baths, 391 

oil of amber, 323 

veratrum viride, 412 

warm bath, 144 
Convulsions, puerperal 

chloral, 193 



INDEX. OF DISEASES. 



463 



Convulsions, puerperal — 

chloroform, 205 
Convulsions, uRiEMic (seeUrsemic 

coma) 
Corns 

acetic acid, 83 

(See Warts) 

CORYZA 

aconite, 108 

alcohol, 118 

assafcetida, 156 

bismuth, 169 

boneset tea, 249 

camphor, 177 

creasote, 233 

cubebs, 234 

Dover's powder, 289 

glycerite of tannin, 259 

horehound, 307 

licorice, 266 

opium, 330 
Cough, spasmodic 

belladonna, 166 

chloroform, 204 

gelsemium, 264 

hydrocyanic acid, 94 

opium, 330 
Cracked nipples 

benzoin, 168 

collodion, 268 

tannic acid, 103 . 
Croup, pseudo-membranous 

alum, 126 

bromine, 363 

chlorate of potash, 356 

ipecacuanha, 291 

lactic acid, 95 

lime-water, 174 

steam, 144 

(See also Diphtheria, and 
Spasm of the larynx) 
Croup, spasmodic 

alum, 126 

antimony, 138 
Cystitis 

buchu, 171 

copaiba, 229 

cubebs, 234 

hyoscyamus, 284 

iron, 255 

juniper, 296 

pareira, 33b 



Cystitis — 

turpentine, 406 
n va ursi, 409 



DEBILITY 
alcohol, 116 

cod-liver oil, 318 

gentian, 265 

iron, 255 

phosphorus, 337 

quinia, 214 

strychnia, 314 

(See also Anaemia) 
Delirium tremens 

antimony, 137 

bromide of potassium, 361 

chloral, 194, 198 

digitalis, 238 

hyoscyamia, 285 

lupulin, 272 

musk, 310 

opium, 327 

veratrum viride, 411 
Diabetes 

almonds 133 

bromide of potassium, 362 

codeia, 335 

glycerine, 265 

opium, 331 

phosphoric acid, 99 

yeast, 251 
Diabetes insipidus 

ergot, 246 

jaborandi, 426 
Diarrhoea 

acetate of lead, 349 

acids, 48 

alum, 126 

arsenic, 153 

bismuth, 170 

blackberry, 374 

cajuput oil, 173 

camphor, 178 

Castillon's powders, 407 

castor oil, 321 

catechu, 190 

chalk, 174 

cinnamon, 221 

copper, 236 

corrosive sublimate, 277 

ergot, 247 



464 



INDEX OF DISEASES. 



DlARRHCEA 

geranium, 265 

gum arabic, 82 

ipecacuanha, 292 

kino, 296 

krameria, 296 

licorice, 267 

lime-water, 174 

logwood, 270 

nitrate of iron, 255 

opium, 330 

ox-bile, 425 

oxide of zinc, 415 

pepsin, 433 

podophyllum, 351 

resin, 371 

rhubarb, 372 

statice, 396 

sulphuric acid, 102 

tannic acid, 259 

testa prseparata, 407 

turpentine, 405 
Diphtheria and Diphtheritic 
croup 

ammonia, 130 

carbolic acid, 85 

chlorate of potassa, 359 

chlorine water. 201 

chromic acid, 88 

citric acid, 88 

ipecacuanha, 291 

lactic acid, 95 

lime inhalations, 174 

muriatic acid, 96 

tincture of iron, 255 

turpentine, 405 
Diphtheritic paralysis 

strychnia, 315 

tartar emetic, 138 
Dislocations 

chloroform, 200 

hemlock, 227 
Drink-craving 

tincture of capsicum, 185 
Dropsy 

blisters, 183 

comp. jalap powder, 294 

copaiba, 230 

cream of tartar, 357 

digitalis, 242 

elaterium, 244 



Dropsy — 

erigeron, 249 

gamboge, 260 

infusion of erigeron, 249 

juniper, 296 

pilocarpin, 428 

potash salts, 357 

scammony, 385 

scoparius, 386 

squill, 386 

spirits of nitre, 122 
Dysentery 

camphor, 178 

ergot, 247 

gum arabic, 82 

Indian bael, 420 

ipecacuanha, 292 

opium, 330 

rhatany, 297 
Dyspepsia 

acids, 46 

aloes, 124 

arsenic, 153 

assafcetida, 155 

belladonna, 166 

bismuth, 169 

bromide of potassium, 362 

carbolic acid, 87 

chamomile, 135 

charcoal, 186 

col umbo, 176 

emetics, 64 

gentian, 265 

hydrocyanic acid, 91, 94 

lactic acid, 94 

lime-water, 174 

magnesia, 305 

muriatic acid, 96 

mix vomica, 316 

ox-bile, 424 

pepsin, 433 

quassia, 370 

quinia, 213 

rhubarb, 372 

senna, 389 

soda, 394 

soda-mint, 394 

sulphurous acid, 103 

sulphate of manganese, 306 

taraxacum, 403 

thoroughwort, 204 



INDEX OF DISEASES. 



465 



ECZEMA 
arsenic, 153 

bicarbonate of potassium, 355 

chloral, 193 

glycerite of tannic acid, 260 

hydrocyanic acid, 91 

lead water, 348 

phosphorus, 339 

soda, 393 

spiritus saponis kalinis, 383 

thymol, 438 

(See also Skin diseases) 
Empyema 

tr. iodine, 288 
Epilepsy 

belladonna, 166 

bromide of ammonium, 133 

bromide of potassium, 360, 363 

Calabar bean, 342 

copper, 236 

nitrite of amyl, 417 

nitro-glycerin, 432 

silver, 148 
Epistaxis 

ergot, 245 

iron, 252 

(See Hemorrhage) • 

Erysipelas 

aconite, 108 

collodion, 268 

elm-poultice, 408 

lead-water, 348 

liquor gutta-perchse, 270 

nitrate of silver, 147 

quinia, 213 

sulphate of iron, 253 

tincture of iron, 254, 255 
Excoriations 

bismuth, 169 

chalk, 174 

lycopodium, 304 

spermaceti cerate, 192 

starch, 134 

(See Skin diseases) 

FACIAL NEURALGIA 
aconite, 106 
gelsemium, 262 
(See also Neuralgia) 
Fainting (see Syncope) 
Fatigue 

alcohol, 116 



Favus 

black-wash, 276 

(See Skin diseases) 
Felon 

carbolic acid, 85 
Fetid expectoration 

creasote, 233 

salicylic acid, 436 
Fever, intermittent (see Ague) 

(See also Typhus and Typhoid) 
Fevers 

acids, 47 

aconite, 108 

althea, 125 

baths, 143 

digitalis, 242 

effervescing draughts, 89 

gum arabic, 82 

liquor ammonii acetatis, 132 

quinia, 213 

salicylic acid, 436 

tartaric acid, 104 

vinegar, 82 
Fissure of rectum 

belladonna, 160 
Flatulence 

aether, 111 

carbolic acid, 87 

charcoal, 186 

cloves, 188 

fennel, 258 

oleum hedeoma, 270 

soda-mint, 394 

sulphurous acid, 103 

(See also Dyspepsia) 
Flooding, post-partum 

ergot, 245 

iron injections, 252 

(See also Hemorrhage) 

GALL-STONES 
belladonna, 166 
chloroform, 205 
hypodermic injections of mor- 
phia, 334 
opium, 329 
warm bath, 144 

GrASTRALGIA 

blisters, 182 

manganesium sulphate, 306 
silver nitrate, 148 
(See also Colic) 



466 



INDEX OF DISEASES. 



GASTROENTERIC inflammation 
gum arabio, 82 

(See also Diarrhoea and Dysen- 
tery) 

GLEET 

copper sulphate, 235 

iron, 255 

styrax, 397 

turpentine, 406 

(See also Gonorrhoea) 
Goitre 

biniodide of mercury, 276 

tincture of iodine, 288 
Gonorrhoea 

alum, 126 

aluminii sulphas, 127 

bismuth, 169 

buchu, 171 

copaiba, 229 

cubebs, 234 

fluid extract of matico, 308 

hydrastis canadensis, 284 

infusion of pomegranate, 
307 

silver nitrate, 147 

storax, 397 

sulphate of copper, 235 

sulphate of zinc, 404 

tannic acid, 259 

turpentine, 405 
Gout 

colchicum, 223 

iodide of potassium, 366 

lithium, 302 

potash, 356 

salicylic acid, 436 
Granular lids 

sulphate of copper, 235 
Gravel 

lithia, 302 

salicylate of soda, 436 



HiEMATEMESIS 
gallic acid, 260 
(See also Haemorrhage) 

HiEMATURIA 

turpentine, 405 
Haemoptysis 

acetate of lead, 349 
alum, 126 
digitalis, 240 



HAEMOPTYSIS 

ergot, 245 

gallic acid, 260 
Haemorrhage 

acetate of lead, 349 

alum, 126 

collodion, 268 

digitalis, 240 

ergot, 245 

erigeron, oil of, 249 

ice, 144 

iron, 252 

matico, 307 

opium, 330 

tannic acid, 259 

turpentine, 405 

(See also Menorrhagia, etc.) 
Haemorrhoids 

belladonna, 160 

charcoal, 187 

ergot, 246 

glycerine, 266 

iodoform, 289 

ointment of galls, 260 

opium fomentations, 327 

nitric acid, 97 

pepper, 345 

sulphur, 399 
Hay-asthma or hay-fever 

arsenic, 152 

quinia, 215 
Headache 

aconite, 107 

nitro-glycerine, 432 

podophyllum, 351 

tincture of nux vomica, 316 

valerian, 43 

valerianate of ammonia, 104, 
410 

vinegar, 82 

(See also Neuralgia) 
Heartburn 

magnesia, 305 

soda mint, 394 

(See also Dyspepsia) 
Heart-clot 

ammonia, 130 
Heart-disease 

aconite, 108 

gather, 112 

belladonna, 162 

comp. jalap powder, 294 



INDEX OF DISEASES. 



467 



Heart-disease — 

digitalis, 239 

hydrocyanic acid, 92 

morphia, 330 

potash-salts, 357 

scoparius, 386 

veratrum viride, 412 
Hepatic disorders 

ammonii chloridum, 133 

blue pill, 277 

citric acid, 89 

ipecacuanha, 292 

leeches, 439 

nitric acid, 98 

nitro-muriatic acid, 98 

podophyllum, 351 

rhubarb, 373 

sodii bicarbonas, 394 
Hernia 

chloroform, 205 

hemlock, 227 

tartar emetic, 138 

warm bath, 144 
Herpes zoster 

collodion, 268 

(See Skin diseases) 
Hiccough 

musk, 310 

oil of amber, 322 
Hydrocele 
• tr. iodine, 288 
Hydrophobia 

woorara, 423 
Hydrothorax 

pilocarpin, 430 

scoparius, 386 

(See also Pleurisy) 
Hypochondriasis 

cimicifuga, 210 

(See Acute and Chronic ma- 
nia) 
Hysteria 

aether, 112 

assafoetida, 156 

catnep, 190 

chloroform, 203 

cloves, 188 

cold water, 143 

hemlock, 227 

musk, 310 

oil of amber, 322 

valerian, 410 



Hysteria — 

valerianates, 12 
valerianate of zinc, 



104 



INFLAMMATIONS 
1 alcohol, 116 
Impetigo 

arsenic, 153 

(See Skin diseases) 
Impotence 

phosphorus, 337 
Incontinence of urine 

belladonna, 25, 164 

bromide of potassium, 361 

buchu, 171 

chloral, 195 

collodion, 268 

ergot, 246 

santonin, 381 

strychnia, 314 
Indigestion 

ipecacuanha, 293 

(See Dyspepsia) 
Infantile convulsions (see Con- 
vulsions, infantile) 
Insanity (see Acute and Chronic 

mania) 
Insomnia 

chloral, 194 

opium, 327 
Intertrigo 

bismuth, 169 

(See Excoriation) 
Intestinal obstruction 

(See Obstruction of Bowels) 
Iritis 

atropia, 161 

blisters, 182 

leeches, 439 
Irritable heart (see Heart 

disease) 
Irritable stomach (see Vomit- 
ing) 
Itch (see Scabies) 



"AUNDICE 

podophyllum, 351 
rhubarb, 373 
sanguinaria, 379 
soda, 94 



408 



INDEX OF DISEASES. 



Jaundice — 

(See also Hepatic disorder) 
Joint-affections 

blisters, 183 

cod-liver oil, 319 

digitalis. 238 

iodine, 288 

oleate of mercury, 276 



JHDNEY COMPLAINT 
L comp. jalap powder, 294 
copaiba, 231 
digitalis, 242 
gallic acid, 260 
iron, 255 
pipsissewa, 193 
potash salts, 357 
(See Bright 's disease) 



LABOR 
chloral, 195 

chloroform, 205 

cotton-root bark, 267 

ergot, 245 

opium, 329 

quinia, 213 
Laryngismus stridulus (see 

Spasm of the larynx) 
Leprosy 

copaiba, 229 

(See Skin diseases) 
Leucocythemia 

phosphorus, 337 

(See also Anaemia) 
Leucorrhoea 

alum, 126 

aluminii sulphas, 127 

bismuth, 169 

ergot, 247 

fluid extract matico, 308 

iron injections, 253 

lime-water, 174 

matico, 308 

sulphate of zinc, 414 

tannic acid, 259 

white-oak bark, 371 
Lichen 

arsenic, 153 

(See Skin diseases) 



Liver-disease (see Hepatic dis- 
orders) 
Locomotor ataxia 

silver oxide, 148 
Lumbago (see Myalgia) 
Lumbricoids (see Worms) 
Lupus 

arsenic, 150 

carbolic acid, 85 

copaiba, 229 

(See Skin diseases) 



MALARIAL FEVERS 
(See Ague) 
Mania (See Acute or Chronic 

mania) 
Mastitis 

belladonna, 165 
Mastodynia 

belladonna, 165 
Measles 

phosphorus, 339 
Meningitis 

blisters, 183 

ice, 144 

opium, 328 
Menorrhagia 

bromide of potassium, 362 

cinnamon, 221 

digitalis, 240, 242 

ergot, 245 

erigeron, 249 

gallic acid, 260 

oil of erigeron, 249 

oxide of silver, 148 

(See also Hemorrhage) 
Migraine (see Neuralgia) 
Mitral disease (see Heart dis- 
ease) 
Myalgia 

ammonium chloride, 130 

atropia injections, 166 

boneset tea, 249 

chloroform, 203 

cimicifuga, 210 

gelsemium, 262 

morphia injections, 334 

mustard plasters, 391 
Myelitis, chronic 

belladonna, 163 



INDEX OF DISEASES. 



469 



ATARCOTIC POISONING: 
ll blisters, 183 

(See also Poisoning) 
Necrosis 

sulphuric acid, 101 
Nervous debility 

phosphorus, 337 

iron, 253 

strychnia, 314 

(See also Debility) 
Nervous headache 

Indian hemp, 180 

valerianate of ammonium, 410 

valerian, 410 

(See also Headache) 
Nervous insomnia 

chloral, 194 

musk, 310 

(See also Insomnia) 
Nervousness 

assafoetida, 156 

camphor, 177 

valerianates, 122 

(See Hysteria) 
Neuralgia 

aether, 111 

aconite, 107, 110 

alcohol, 115 

ammonium chloride, 130, 133 

apiol, 434 

arsenic, 150 

belladonna, 160 

blisters, 182 

cannabis Indica, 180 

chloral, 193 

chloral-camphor, 199 

chloroform, 203 

cochineal, 222 

cod-liver oil, 318 

croton-chloral, 200 

guar ana, 172 

gelsemium, 262 

hydrocyanic acid, 91 

hypodermic injections of mor- 
phia, 334 

Indian hemp, 180 

iodoform, 289 

iron, 253 

mustard plaster, 391 

nitrite of amyl, 418 

oil of peppermint, 309 

opium, 329 
40 



Neuralgia — 

quinia, 214 

salicin, 434 

turpentine stupes, 405 

valerianate of quinia, 104 

veratria ointment, 376 

(See also Headache, Toothache, 
Myalgia, and Pleurodynia) 
Night sweats 

acetic acid, 82 

atropia, 165 

ergot, 245 

oxide of zinc, 415 

quinia, 215 

sulphuric acid, 100 
Nipples, sore (see Cracked nip- 
ples) 



OBSTRUCTION OF BOWELS 
belladonna, 164 

acetate of lead, 350 
QSdema (see Dropsy) 
CEdema op glottis 

chromic acid, 88 
Onychia maligna 

nitrate of lead, 348 
Ophthalmia (see Conjunctivitis) 
Orchitis 

ice, 144 

leeches, 439 
Otorrhea 

glycerite of tannic acid, 260 
Oxyuris vermicularis (see 
Worms) 

OziENA 

creasote, 233 

glycerite of tannic acid, 260 
potassium permanganate, 355 
(See also Coryza) 



PAINTERS' COLIC 
alum, 126 
belladonna, 164 
chloroform, 203 
Epsom salt, 305 
iodide of potassium, 365 
sulphuric acid, 102 
Palpitation of the heart 
belladonna, 162 



470 



INDEX OF DISEASES. 



Palpitation of the heakt — 

chloroform, 203 

digitalis, 239 

opium, 330 

(See also Heart disease) 
Paralysis 

ergot, 245 

strychnia, 315 
Paralysis agitans 

hemlock, 227 
Paraplegia (see Paralysis) 
Parturition (see Labor) 
Pediculi 

black wash, 276 
Pemphigus 

arsenic, 153 
Pericarditis 

blisters, 183 

leeches, 439 

mercury, 279 
Periostitis 

iodide of potassium, 365 
Peritonitis 

aconite, 108 

blisters, 183 

flaxseed poultices, 300 

leeches, 439 

mustard, 391 

opium, 329 

turpentine stupes, 405 
Phagedena 

chromic acid, 88 

iron, 253 

nitric acid, 97 

quinia, 213 
Phthisis 

arsenic, 152 

chloral, 194 

cod-liver oil, 317 

hypophosphite of lime, 175 

lactucarium, 297 

opium, 330 

oxalic acid, 99 

wild-cherry bark, 369 
Piles (see Haemorrhoids) 
Pityriasis capitis 

chloral, 193 

calomel ointment, 278 
Pleurisy 

aconite, 108 

blisters, 182 
leeches, 439 



Pleurisy — 

mustard, 391 

pilocarpin, 428 

turpentine stupes, 405 
Pleurodynia 

blisters, 182 

mustard, 391 

iodine, 288 

(See also Neuralgia) 
Pneumonia 

aconite, 108 

ammonia, 130, 131 

antimony, 138, 140 

blisters, 182 

diaphoretics, 60 

flaxseed poultices, 300 

iodine, 288 

mercury, 279 

mustard, 391 

opium, 330 

quinia, 213 

senega, 388 

turpentine stupes, 405 

veratrum viride, 412 
Podagra (see Gout) 
Polypi, uterine 

ergot, 246 

(See also Menorrhagia) 
Polyuria (see Diabetes insipidus) 

POST-PARTUM HEMORRHAGE 

iron, 252 

iodine (see also Hemorrhage) 
Priapism 

bromide of potassium, 362 

camphor, 176 
Prolapsus ani 

bismuth, 169 
Pruritus 

calomel ointment, 278 

chloral-camphor, 199 

hydrocyanic acid, 91, 94 

soda, 393 

tobacco, 401 

(See also Skin diseases) 
Psoriasis 

antimony, 139 

arsenic, 153 

cantharides, 184 

chrysophanic acid, 425 

copaiba, 229 

Goa powder, 425 

phosphorus, 339 



INDEX OF DISEASES. 



4U 



Psoriasis — 

tar ointment. 346 

thymol, 43 
Puerperal convulsions (see Con- 
vulsions) 
Pulmonary complaints 

Iceland moss, 192 

(See Phthisis, Pneumonia, and 
Pleurisy) 
Purpura 

ergot, 246 

turpentine, 405 

(See also Scurvy) 
Pyaemia 

alcohol, 117 

quinia, 213 
Pyelitis 

cantharides, 184 

turpentine, 406 
Pyrosis 

bismuth, 170 

magnesia, 305 

manganesium sulphate, 306 

sulphurous acid, 103 

(See also Dyspepsia) 



AUINSY (see Tonsillitis) 



EACHITIS 
cod-liver oil, 319 

iron, 254 

phosphate of lime, 175 

phosphoric acid, 100 

phosphorus, 339 
Renal calculus 

chloroform, 205 

opium, 329 

warm bath, 144 

(See also Calculus) 
Rheumatism 

aconite, 108 

arsenic, 154 

baths, 143 

belladonna, 160, 166 

blisters, 182 

bromide of ammonium, 130 

chloral, 193 

cimicifuga, 210 

citric acid, 89 



Rheumatism — 

cod-liver oil, 319 

cotton-wadding, 267 

Dover's powder, 293 

guaiac, 269 

iodide of potassium, 366 

iron, 255 

lemon-juice, 299 

oil of cajuput, 173 

oil of monarda, 310 

pilocarpin, 428 

pipsissewa, 193 

potassium salts, 356 

quinia, 213 

salicin, 434 

salicylic acid, 435 

sulphur, 398 

trimethylamine, 439 

(See also Myalgia) 
Rheumatoid arthritis 

arsenic, 154 

guaiac, 269 
Rickets (see Rachitis) 
Ringworm 

acetic acid, 153 

(See also Skin diseases) 
Rupture op bladder 

opium, 329 
Rupture of intestine 

opium, 329 
Rupture op uterus 

opium, 329 



OALIVATION 

U belladonna, 164 

chlorate of potash, 356 
Sarcixous vomiting 

carbolic acid, 87 

eucalyptus, 424 

hyposulphite of soda, 394 

sulphurous acid, 103 

(See also Vomiting) 
Scabies 

arsenic, 153 

storax, 397 

sulphur ointment, 398 
Scarlet pever 

aconite, 108 

ammonii carbonas, 132 

belladonna, 166 

chlorate of potassium, 356 



412 



INDEX OF DISEASES. 



Scarlet fever — 

chlorine water, 202 

phosphorus, 339 

quinia, 213 
Sciatica 

atropia injections, 166 

hlisters, 182 

hypodermic injections of mor- 
phia, 334 

mustard, 391 

opium, 329 

turpentine enema, 406 

(See also Neuralgia) 
Scorbutus (see Scurvy) 
Scrofula 

harium chloride, 159 

calcium chloride, 175 

cod-liver oil, 319 

comp. tinct. of iodine, 287 

iodine, 288 

iron, 254 

phosphoric acid, 100 

pipsissewa, 193 

stillingia, 396 
Scurvy 

chromic acid, 88 

citric acid, 89 

lemon-juice, 299 

oxalic acid, 99 

vinegar and nitre, 82 
Sea-sickness 

hromide of potassium, 362 

chloral, 196 

chloroform, 203 
Sick-headache (see Headache) 
Seminal emissions 

belladonna, 161 
Skin diseases 

acetic acid, 83 

antimony, 139 

arsenic, 150, 153 

hismuth, 169 

black-wash, 275 

cadmium salts, 172 

carbolic acid, 84 

chloral, 193 

chloroform, 203 

chrysophanic acid, 425 

cod -liver oil, 319 

collodion, 268 

copaiba, 229 

creasote, 233 



Skin diseases — 

dulcamara, 243 

Groa powder, 425 

hydrocyanic acid, 91 

hyposulphite of soda, 393 

iodine, 288 

lycopodium, 304 

mercurial ointment, 276 

nitrate of lead, 348 

oxide of zinc ointment, 414 

phosphorus, 339 

sapo viridis, 383 

soda, carbonate of, 393 

starch, 134 

stillingia, 396 

sulphur baths. 399 

sulphurous acid, 102 

tar ointment, 346 

thymol, 438 

warm bath, 144 

(See Acne faciei, Eczema, Ery- 
sipelas, Excoriations, Favus, 
Herpes zoster, Impetigo, Le- 
prosy, Lichen, Lupus, Ony- 
chia maligna, Pemphigus, 
Prurigo, Psoriasis, Ring- 
worm, Scabies, Smallpox, 
and Tinea Tonsurans) 
Sloughing 

nitric acid, 97 
Smallpox 

alcohol, 117 

quinia, 215 
Smallpox- pittin g 

collodion, 268 

liquor gutta perchse, 270 

mercurial ointment, 276 

silver nitrate, 147 
Snake-bite 

ammonia, 129, 132 
Sore throat 

alum, 126 

chlorate of potash, 359 

compound infusion of roses, 324 

corrosive sublimate, 276 

glycerite of tannic acid, 260 

gum arabic, 82 

iodoform, 289 

iron, 253 

myrrh, 312 

rosemary, 396 

sage tea, 378 



INDEX OF DISEASES. 



473 



Sore throat — 

tannic acid, 260 

(See also Tonsillitis) 
Spasm of the larynx 

antimony, 138 

bromide of potassium, 361 

cold affusions, 143 

compound syrup of squill, 385 

conium, 227 
Spasmodic stricture 

(See Stricture) 
Spleen, enlarged 

conium, 227 

fluid extract of ergot, 247 

opium, 329 

quinia, 216 
Sprains and bruises 

laudanum, 327 

lead-water, 348 

vinegar, 82 
Stings of insects 

ammonia, 128 
Stomatitis 

bismuth, 169 

cliromic acid, 88 
Stone in the bladder (see Cal- 
culus) 
Stricture, spasmodic 

hemlock, 227 

iron, 255 

opium, 327 

warm bath, 144 
Struma (see Scrofula) 
Stupor (see Ursemic coma and 

Narcotic poisoning) 
Suffocative catarrh (see Bron- 
chitis) 
Summer complaint (see Diar- 
rhoea) 
Sunburn 

vinegar, 82 
Sunstroke 

cinchona, 212 
Suppurating glands (see Scro- 
fula) 
Sweating 

acids, 46 

alum, 126 

atropia, 165 

belladonna, 160 
Sweating of phthisis (see Night- 
sweats) 

40 



Syncope 

ammonia, 129 
Syphilis 

bichromate of potassium, 359 

black-wash, 275 

chromic acid, 88 

cod-liver oil, 319 

corrosive-sublimate injections, 
281 

guaiac, 269 

iodide of potassium, 366 

iron, 254 

mercury, 276, 279 

nitric acid, 97 

sarsaparilla, 334 

stillingia, 396 

Zittmann's decoction, 283 
Syphilitic brain-disease 

mercury, 279 
Syphilitic sore-throat 

black-wash, 279 

corrosive sublimate gargle, 
281 

silver nitrate, 147 

sulphate of copper, 235 
Syphilitic ulcer 

acid nitrate of mercury, 275 

iodoform, 289 

nitrate of silver, 147 

sulphate of copper, 235 

sulphuric acid, 108 



TAENIA (see Worms) 
Tapeworm (see Worms) 
Tetanus 

bromide of potassium, 361 

cannabis Indica, 180 

chloral, 195 

conium, 227 

curare, 422 

gelsemium, 263 

nitrite of amyl, 418 

physostigma, 342 

tobacco, 402 

woorara, 422 
Tinea tonsurans 

carbolic acid, 86 

black-wash, 276 

iodine, 288 

sulphurous acid, 102 

(See also Skin diseases) 



474 



INDEX OF DISEASES. 



Tinea versicolor 

sulphurous acid, 102 
Tinea circinata 

Goa powder, 425 
Tonsillitis 

aconite, 108 

capsicum-gargle, 185 

steam, 144 
Tonsils, enlarged 

chromic acid, 88 
Toothache 

atropia, 166 

cajuput oil, 173 

creasote, 233 
Torticollis 

coni urn, 227 
Trismus nascentidm 

chloral, 195 
Trismus 

hemlock, 227 

(See also Tetanus) 
Tympanites 

assafcetida, 156 

turpentine, 405 
Typhoid condition 

alcohol, 117 

ammonia, 130 

phosphorus, 338 
Typhoid fever 

alcohol, 117 

ammonia, 130 

digitalis, 241 

ergot, 246 

muriatic acid, 96 

opium, 327 

quinia, 213 

turpentine, 405 

veratrum viride, 412 
Typhus 

alcohol, 117 

antimony, 137, 140. 

blisters, 183 

chloral, 194 

chlorine-water, 202 

opium, 327 

quinia, 213 



ULCERATED SURFACES 
carbolic acid, 85 
bismuth, 169 
silver nitrate, 147 



Ulcers 

acid nitrate of mercury, 275 

carbolic acid, 85 

charcoal poultices, 186 

chromic acid, 88 

copper sulphate, 236 

iodoform, 289 

nitrate of silver, 147 

potassium permanganate, 353 

yeast poultice, 251 
Uremic coma 

cathartics, 71 

croton oil, 324 

diaphoretics, 61 

diuretics, 63 

mustard poultices, 391 
Uterine cancer 

iodoform, 289 

(See Cancer) 
Uterine polypi 

ergot, 247 



VARICOSE VEINS 
ergot, 246 
Vesical catarrh 

buchu, 171 

(See Cystitis) 
Vesical irritations 

benzoin, 168 

hyoscyamus, 284 

pareira, 336 
Vesical irritability 

iron, 255 

sodium bicarbonate, 394 

(See Calculus) 
Vomiting 

arsenic, 153 

bismuth, 170 

carbolic acid, 88 

creasote, 233 

dilute hydrocyanic acid, 91 

ice, 144 
Vomiting, persistent 

calomel, 25, 277 

chloroform, 204 

effervescing draught, 89 

gray powder, 25, 277 

ice, 144 

ipecacuanha, 25, 291 

(See also Sarcinous vomit- 






ing) 



INDEX OP DISEASES. 



475 



Vomiting of pregnancy 
aconite, 109 

bromide of potassium, 361 
ipecacuanha, 25, 291 
oxalate of cerium, 191 
tincture of nux vomica, 316 



WARTS 
acetic acid, 83 

bichromate of potassium, 359 

chromic acid, 88 

nitric acid, 97 

silver nitrate, 147 
Whooping-cough 

alum, 126 

antimony, 138 

assafoetida, 156 

belladonna, 164 

bromide of ammonium, 133 

bromide of potassium, 361 

camphor, 177 

carbolic acid, 88 

chloral, 195 

chloroform, 205 

cochineal, 222 

cod-liver oil, 318 

ergot, 245 

hydrocyanic acid, 91 

oil of amber, 323 

quinia, 215 

squill, 385 
Winter-cough 

(See Bronchitis) 



Worms (for general remarks > on 

Anthelmintics see page 49) 
Ascaris lumbricoides (Round 
worms) 

azedarach, 420 

oil of wormseed, 192 

santonin, 381 

scammony, 385 

spigelia, 395 

turpentine, 406 
Oxyuris vermicularis (Seat- 
worms) 

enemata of iron, 253 

enemata of lime-water, 174 

enemata of quassia, 371 

enemata of vinegar, 82 
Taenia (Tape-worms) 

carbolic acid, 88 

filix mas, 258 

infusion of pomegranate, 370 

kamala, 431 

kousso, 421 

pumpkin seeds, 337 

rottlera, 431 

turpentine, 406 
Trichina spiralis 

general treatment, 50 
Wrist-drop 
strychnia, 315 
(See Lead-poisoning) 
Wry neck 
hemlock, 227 
(See Myalgia) 



GENERAL INDEX. 



A 1 



BSINTHE, 81 
J\ Absinthium, 81 
Acacia, 81 
Accumulation of arsenic, 154 

of digitalis, 243 

of medicine, 29 

of strychnia, 316 
Aceta, 84 
Acetic acid, 82 
Acetum, 82 

destillatum, 82 

lobeliae, 302 

opii, 325 

sanguinariae, 379 

scillae, 385 
Acid a, 105 

Acid, chiysophanic, 425 
Acids in biliary derangement, 47 

disadvantages of, 48 

effect on circulation, 45 

effects on secretion, 47 

effects on temperature, 46 

effects on the urine, 47 

external effects, 46 

internal effects, 46 

officinal, 105 

poisonous effects of, 48 

remarks on, 45 

stimulating alkaline secre- 
tions, 47 
Acidum aceticum, 82 

aceticum dilutum, 82 

arseniosum, 84, 149 

benzoicum, 168 

carbolicum, 84 

carbolicum impurum, 84 

chromicum, 88 

citricum, 88, 298 

gallicum, 259 

hydrocyanicum dilutum, 89 

lacticum, 94 

muriaticum, 95 

muriaticum dilutum, 95 



Acidum nitricum, 97 

nitricum dilutum, 97 

nitro-muriaticum, 98 

nitro-muriaticum dilutum, 98 

oxalicum, 99 

phosphoricum dilutum, 99 

phosphoricum glaciale, 99 

salicylicum, 435 

sulphuricum, 100 

sulphuricum aromaticum, 100 

sulphuricum dilutum, 100 

sulphurosum, 102 

tannicum, 103-259 

tartaricum, 103 

valerianicum, 104 
Acne from bromides, 363 

prevented by arsenic, 21 
Aconite, 105 

in fever, 24-107 

leaves, 105 

root, 105 
Aconitia, 105 
Aconiti folia, 105 

radix, 105 
Aconitum, 105 
Action of drugs changed with 

dose, 25 
Adeps, 110 
Administration, forms of, 18, 22 

of aconite, 109 

of antimony, 140 

of opium, 334 

of purgatives, 70 

of quinia, 218 
^Ether, 110 

fortior, 111 
^Etherea, 114 
Alcohol, 114 

amylicum, 122 

dilutum, 114 

fortius, 114 
Alcohol as food, 119-120 

amount of in liquors, 121 



478 



GENERAL INDEX. 



Alkaloids in cinchona, 220 
Allium, 122 
Allspice, 344 
Almond, 133 

as food in diabetes, 134 

mixture, 133 
Aloe, 123 

Barbadensis, 123 

Capensis, 123 

compound decoction of, 125 

purificata, 123 

Socotrina, 323 
Aloes, 123 
Althaea, 125 
Alum, 125 
Alumen, 125-128 

exsiccatum, 125 
Aluminii et potassii sulphas, 
127 

sulphas, 127 
Amber, 322 
American hellebore, 411 

leeches, 439 

pennyroyal, 270 
Ammonia, 127 
Ammoniac, 127 
Ammoniacum, 127 
Ammoniated copper, 234 

mercury, 128 
Ammonii benzoas, 128, 168 

bromidum, 128, 170 

carbonas, 128 

chloridum, 128 

chloridum purificatum, 128 

iodidum, 128 

nitras, 128 

salicylas, 435 

sulphas, 128 

valerianas, 104-122, 128 
Ammonio-ferric alum, 128 
Ammonio-tartrate of iron, 128 
Amygdala amara, 133 

dulcis, 133 
Amygdalus, 133 
Amyl nitris, 417 
Amylic alcohol, 122 
Amylum, 134 
Anaesthesia by chloroform, 204 

by chloral, 194 

by ether, 113 

by nitrous oxide gas, 423 
Anaesthetic, local, 85 



Anaesthetics, 48 

choice of, 48 
Angustura, 134 
Anise, 135 
Anise-seed, 135 
Anisum, 135 
Anthelmintics, 49 

how to give, 24, 51 
Anthemis, 135 
Antidote, acetic acid, 83 

aconite, 105 

general, for poisons, 440 
Antidote, alcohol, 115 

ammonia, 129 

arsenious acid, 150 

barium, 159 

belladonna, 159 

bitter almond, 134 

bromine, 171 

camphor, 177 

carbolic acid, 85 

chemical, 53 

chloral, 196 

conia, 226 

copper, 235 

corrosive poisoning, 275 

corrosive sublimate, 275 

digitalis, 237 

Fowler's solution, 150 

hydrocyanic acid, 90, 93 

iodine, 287 

lead, 348 

lobelia, 302 

muriatic acid, 95 

nitrate of silver, 147 

nitric acid, 97 

oil of bitter almonds, 134 

opium, 326 

oxalic acid, 99 

phosphorus, 337 

physiological, 53 

physostigma, 341 

potassa, 354 

stramonium, 397 

strychnia, 313 

sulphuric acid, 101 

tartar emetic, 137 

tartaric acid, 104 

tobacco, 400 

veratria, 375 

zinc, 413 
Antidotes, theory of, 51 






GENERAL INDEX. 



479 



Antimonial powder, 139 

wine, 136 
Antimonii et potassii tartras, 
135 

et potassii tartras, in infantile 
bronchitis, 25 

et potassii tartras, toleration 
of, 29 

oxidum, 135 

oxysulphuretum, 138 

sulphuretum, 135 
Antimonium, 135 

sulphuratum, 136 
Antimony, 135 

Antipyretics and refrigerants, 53 
Antiseptic system of Lister, 86 
Antiseptics, action of, 57 

and disinfectants, 56 

properties of charcoal, 186 

solution of chloral as an, 193 

tincture of iodine, 287 
Apiol, 434 
Apomorphia, 335 
Appollinaris water, 146 
Aqua, 141 

acidi carbolici, 84 

acidi carbonici, 145, 307 

ammonia?, 128 

ammonia? fortior, 127 

amygdala? amara?, 133 

anisi, 135 

aurantii norurn, 157 

camphorae, 176 

chlorini, 201 

cinnamomi, 221 

creasoti, 233 

destillata, 141 

foeniculi, 258 

laurocerasi, 432 

mentha? piperita?, 309 

mentha? viridis, 309 

rosa?, 374 
Aqua?, 146 
Araroba, 425 
Areca nut, 418 
Argenti cyanidum, 89, 146 

nitras, 146 

nitras fusa, 147 

oxidum, 147 
Argentum, 146 
Arnica, 148 
Arrowroot, 307 



Arsenic, 149 

constitutional effects of, 152 

in childhood, 34 

in skin disease, toleration of, 29 

white, 149 
Arsenic-eating in Styria, 28, 154 
Arsenicum, 149 
Arsenici iodidum, 148 
Arsenious acid, 84, 149 
Ascaris lumbricoides, 50 
Assafcetida, 155 
Asthma cigarettes, 167 
Astringents and caustics, 59 
Atropia, 159 
Atropia? sulphas, 159 
Aurantii amari cortex, 156 

dulcis cortex, 156 

tlores, 156 
Aurantium, 156 
Avena? farina, 157 
Azedarach, 418 



BALSAM of Peru, 158 
of Tolu, 158 
Balsamum Peruvianum, 158 

Tolutanum, 158 
Barbadoes aloes, 123 
Barii carbon as, 158 

chloridum, 158 
Bark, cinchona, 210 
Barley, 271 
Bath, nitric acid, 97 
Baths, therapeutic effects of, 142 
Bay rum, 395 
Bearberry, 409 
Bebeeru bark, 313 
Bel a? fructus, 420 
Belladonna, 159 

effects on animals, 167 

effects on rabbits, 40 

in childhood, 33 

leaves, 159 

root, 159 

poisoning, 159 

(See Poisoning in Index of 
Diseases) 
Belladonna? folia?, 159 

radix, 159 
Benzoate of ammonium, 168 
Benzoated lard, 168 
Benzoic acid, 168 



480 



GENERAL INDEX. 



Benzoin, 168 

Benzoinum, 168 

Betel nut, 418 

Bichromate of potassium, 359 

Bismuth, 169 

subearbonate of, 169 

subnitrate of, 169 
Bismuthi subcarbonas, 169 

subnitras, 169 
Bismuth um, 169 
Bitter almond, 133 
Bittersweet, 243 
Blackberry , 374 
Black draught, 389 
Black drop, 325 
Black hellebore, 271 
Black-wash, 275 
Black snake-root, 210 
Blistering collodion, 268 

papers, 181 
Blisters, caution in use of, 184 

therapeutic indications for, 184 
Bloodroot, 379 
Bone, 336 
Boneset tea, 249 
Borax, 392 
Brandy, 396 
Brayera, 421 

Bromide of ammonium, 170 
Bromide of potassium, 170 
Bromide acne, 363 
Bromine, 170 
Brominium, 170 
Broom, 386 

Brown mixture, 81, 266 
Buchu, 171 
Buckthorn, 434 
Burgundy pitch, 345 
Burnett's disinfecting fluid, 413 
Butternut, 295 
Butyl chloral-hydrate, 199 



CACAO butter, 323 
Cadmii sulphas, 172 
Cadmium, 172 
Caffea, 172 
Caffeine, 172 
Cajeput oil, 173 
Calabar bean, 341 
Calcii carbonas prsecipitata, 173 
chloridum, 173 



Calcii — 

hypophosphis, 173 

phosphas prsecipitata, 173 
Calcis hydras, 173 
Calcium, 173 
Calomel, 272 
Calumbo, 175 
Calx, 173 

Calx chlorinata, 173 
Camphor, 176 
Camphora, 176 
Canada fieabane, 249 
Canada pitch, 345 
Canada turpentine, 404 
Canella, 179 
Canna, 179 

Cannabis Americana, 179 
Cannabis Indica, 179 
Cantharides, 181 
Cantharis, 181 
Cape aloes, 123 
Capsicum, 185 
Caraway, 188 
Caraway seed, 188 
Carbo, 185 

animalis purificatus, 185 

ligni, 185 
Carbolic acid, 84 

ointment, 84 
Carbon, 185 

Carbonated waters, 145 
Cardamom, 187 
Cardamomum, 187 
Carrageen, 210 
Carron oil, 174 
Carum, 188 
Caryophyllus, 188 
Casca bark, 421 
Cascarilla, 189 
Cassia fistula, 189 
Cassia Marilandica, 189 
Castillon's powders, 407 
Castor, 189 
Castoreum, 189 
Castor oil, 321 
Cataria, 190 
Catechu, 190 
Catnep, 190 
Catnep-tea, 190 

Caution in regard to arsenic in 
skin disease, 153, 154 

in regard to chloral, 197 






GENERAL INDEX. 



481 



Caution — 

in regard to chloroform, 208 

in regard to opium in bron- 
chitis, 230 

in regard to blisters, 184 
Cayenne pepper, 185 
Cera alba, 191 

ilava, 191 
Cerata, 190 
Cerate of cantharides, 181 

of extract of cantharides, 181 
Cerates, officinal, 190 
Ceratum, 110 

cantharidis, 181 

cetacei, 192 

extracti cantharidis, 181 

plumbi subacetatis, 177, 347 

resinae, 371 

resinae compositum, 300, 371 

sabinae, 377 

saponis, 382 

zinci carbon atis, 413 
Cerii oxalas, 191 
Cerium, 191 

oxalate, 191 
Cerum, 191 
Cetaceum, 191 
Cetraria, 192 
Cevadilla, 375 
Chalk, 173, 233 
Chalk-lozenges, 173 
Chalybeate waters, 145 
Chamomile, 135 
Chamomile, German, 308 
Charcoal, purified animal, 185 

wood, 185 
Charta cantharidis, 181 

sinapis, 391 
Chartse, 192 
Chemical antidotes, 53 
Chenopodium, 192 
Cherry-laurel leaves, 432 
Children, how to prescribe for, 33 
Children's diseases, pilocarpia 

in, 429 
Chimaphila, 192 
Chiretta, 193 
Chloral, 193 

as an anaesthetic, 194 

caution in bronchitis, 196 

contra-indicated in heart dis- 
ease, 195 
41 



Chloral-camphor, 199 
Chloral hydrate, 193 
Chloric ether, 210 
Chloride of ammonium, 128 
Chloride of calcium, 173 
Chlorine, 201 
Chlorine water, 201 
Chlorinated lime, 173 
Chlorinum, 201 
Chloroform, 202 

how to give, 208 
Chloroformum, 202 
Chloroformum purificatum, 202 

venale, 202 
Cholagogue purgatives, 72 
Cholagogues, emetics as, 65 
Chondrus, 210 
Chorea, toleration of sulphate of 

zinc in, 29 
Chromic acid, 88 
Chrysophanic acid, 373, 425 
Cimicifuga, 210 
Cinchona, 210 
Cinchona flava, 210 

pallida, 210 

rubra, 211 
Cinchona-red, 220 
Cinchonia, 220 
Cinchoniae sulphas, 211 
Cinchonidia, 220 
Cinnamomum, 221 
Cinnamon, 221 
Citric acid, 88 
Citrine ointment, 273 
Classification of drugs, 80 
Clover on anaesthetics, 48 

on chloroform, 207, 208, 209 
Cloves, 188 
Coca, 172 
Coccus, 221 
Cochineal, 221 
Codeia, 335 
Cod-liver oil, 317 

inunctions, 317 

when to give, 23 
Coffee, 172 
Colchici radix, 222 

semen, 222 
Colchiceine, 224 
Colchicia, 223 
Colchicum, 222 
Cold affusions, 143 



482 



GENERAL INDEX- 



Cold baths in fever, 143 

Cold pack, 144 

Cold cream, 374 

Collodion, 268 

Collodium, 207, 268 

Collodium cum cantharide, 181, 

268 
Collodium flexile, 268 
Colocynth, 224 
Colocynthis, 224 
Columbo, 175 

Combination of drugs, 20 . 
Compound cathartic pills, 272 
Compound spirit of ether, 121 
Confectio aromatica, 221 

aurantii corticis, 157 

opii, 325 

rosse, 374 

sennse, 388 
Confectiones, 225 
Confections, officinal, 225 
Confection of orange peel, 157 
Congress-spring water, 145 
Conii folia, 225 

fructus, 225 
Conium, 225 
Constitutional effects from small 

doses, 29 
Contents, table of, ix 
Copaiba, 229 
Copper, 234 
Coptis, 232 
Coriander, 232 
Coriandrum, 232 
Cornus Florida, 232 
Corrosive sublimate, 272 
Cotton, 267 
Cotton-root bark, 267 
Cough-medicines, how combined, 

22 
Counter-irritation, theory of, 59 
Counter-irritants, 59 
Court-plaster, 286 
Cranesbill, 265 
Cream of tartar, 354 
Creasote, 233 
Creasotum, 233 
Creta, 173, 233 
Creta pr?eparata, 173 
Crocus, 233 
Croton-chloral, 199 
Croton oil, 323 



Cryptopia, 335 
Cubeb, 233 
Cubeba, 233 
Culver's root, 298 
Cupri subacetas, 234 

sulphas, 234 
Cuprum, 234 

Cuprum ammoniatum, 128, 234 
Curare, 422 
Curcuma, 423 
Cusparia, 134 
Cyanide of mercury, 89 

of silver, 89 

of potassium, 90 



DATURLA, 397 
Decocta, 237 
Decoction of aloes, 125 

of Zitmann, 283 
Decoctions, officinal, 237 
Decoctum cetraria?, 192 

chimaphilse, 192 

cinchona? flavse, 211 

cinchonse rubra?, 211 

cornus Florida?, 232 

dulcamara?, 243 

hsematoxyli, 270 

hordei, 271 

quercus alba?, 371 

sarsaparilla? compositum, 383 

senega?, 387 

uva? ursi, 409 

Zittmanni, 283 
Deodorized tincture of opium, 

325 
Diagnosis between cholera and 
arsenical poisoning, 149 

of opium poisoning, 326 
Dialyzed iron, 430 
Diaphoretics, action of, 60 

classes of, 60 
Digitalinum, 237 
Digitalis, 237 

accumulation of, 30 

hints on prescribing, 30 

toleration of, 29 
Dilute acetic acid, 82 

alcohol, 114 

hydrocyanic acid, 89 

nitric acid, 97 

nitro-muriatic acid, 98 



GENERAL INDEX. 



483 



Dilute— 

phosphoric acid, 99 

sulphuric acid, 100 
Diseases from drinking water, 144 
Disguising taste of drugs, 35 
Disinfectant, chlorine as a, 201 
Disinfectants, antiseptics and, 56 

classes of, 57 

theory of, 57 
Distilled vinegar, 82 

water, 141 
Diuretic, copaiba as a, 230 

effect of digitalis, 242 
Diuretics, action of, 61 

classes of, 61 

how to aid, 22 
Dogwood, 232 
Donovan's solution, 149 
Dosage, 24 

Dose, action of drugs altered 
with, 25 

constitutional effects from 
small, 29 

exceptions to rule, 39 

for children, 34, 35 

general observations upon, 38 

general rule for, 39 

interval between, 26 

of medicines, 24 
Dosing, principles of, 24 
Dover's powder, 289 
Drastic purgatives, 71 
Dried alum, 125 

Drugs, chemical and physiologi- 
cal incompatibilities of, 30 

classification of, 80 

combination of, 20 

proper time of giving, 22 
Drysdale, treatment of croup, 359 
Dulcamara, 243 



T7ARTH as a disinfectant, 57 

Vj Ecbolics, action of, 65 

Effervescing draughts, 89 

E^g, 336 

Elaterin, 244 

Elaterium, 244 

Elder, 378 

Elixir of cinchona flava, 221 

Elixir of jaborandi, 425 

Emetia, 294 



Emetic action of copper, 236 

alum, 125 

antimony, 136 

apoinorphia, 335 

chamomile tea, 135 

mustard. 390 
Emetics, action of, 63 

as antidotes, 52 

as cholagogues, 65 

direct, 64 

effects on circulation of, 65 

effect on nervous system of, 65 

effects on secretion of, 65 

free perspiration caused by, 65 

indirect, 63 
Emmenagogue, aloes as an, 124 

cotton -root bark, 267 

cimicifuga, 210 
Emmenagogues and Ecbolics, 65 

direct, 65 

indirect, 65 
Emplastra, 244 
Emplastrum aconiti, 105 

ammoniaci, 127 

ammoniaci cum hydrargyro, 
127, 272 

antimonii, 136 

arnica? , 148 

assafcetidse, 156 

belladonna?, 159 

ferri, 252 

galbani compositum, 259 

hydrargyri, 272 

opii, 325 

picis Burgundicae, 345 

picis Canadensis, 345 

picis cum cantharide, 181 

plumbi, 347 

resinae, 371 

saponis, 382 
Emulsion of cod-liver oil, 320 
Endermic medication, 15 
Enemata, nutritive, 17 

purgative, 17 
Epidermic medication, 15 
Epsom salt, 304 
Ergot of rye, 245 
Ergota, 245 
Ergotine, 245 
Ergotism, 246, 248 
Erigeron, 249 

Canadense, 249 



484 



GENERAL INDEX. 



Erysipelas caused by arnica, 148 
Eruption of copaiba, 231 
Eserina, 344 
Ether, 110 
Ethereal oil, 317 
Ethers, officinal, 114 
Eucalyptus globulus, 424 
Eupatoriuni, 249 
European worm-seed, 379 
Expectorants, 66 
Extracta, 250 
Extracts, officinal, 250 
Extractum aconiti, 105 

arnica?, 148 

belladonna?, 159 

belladonna? alcoholicum, 159 

belladonna? radicis fiuidum,159 

buchu liuidum, 171 

ealumba? fluidum, 175 

canabis Americana?, 179 

canabis Indica?, 179 

chimaphila? fluidum, 192 

cimicifuga? fluidum, 210 

cinchona?, 211 

cinchona? fluidum, 211 

colchici aceticum, 222 

colchici radicis fluidum, 222 

colchici seminis fluidum, 222 

colocynthidis, 224 

colocynthidis compositum, 187, 
224, 384 

conii, 225 

conii alcoholicum, 225 

conii fructus fluidum, 225 

cornus Florida? fluidum, 232 

cubeboe fluidum, 233 

digitalis, 237 

digitalis liuidum, 237 

dulcamara?, 243 

dulcamara? fluidum, 243 

ergota? fluidum, 245 

erigerontis Canadensis fluid- 
um, 249 

gelsemii fluidum, 262 

gentiana?, 264 

gentiana? fluidum, 264 

geranii fluidum, 265 

glycyrrhiza?, 266 

glycyrrhiza? fluidum, 266 

gossypii radicis fluidum, 267 

ha?matoxyli, 270 

hellebori, 271 



Extractum — 

hydrastis fluidum, 283 
hyoscyami, 284 
hyoscyami alcoholicum, 284 
hyoscyami fluidum, 284 
ignatia?, 286 

ipecacuanha? fluidum, 289 
jalapa?, 294 
juglandis, 295 
krameria?, 296 
krameria? fluidum, 296 
lupulina? fluidum, 271 
matico fluidum, 307 
mezerei fluidum, 309 
nucis vomica?, 313 
opii, 325 

pareira? fluidum, 336 
physostigmatis, 341 
pinus Canadensis fluidum, 345 
podophylli, 351 
pruni Virginiana? fluidum, 369 
quassia?, 370 
rhei, 372 
rhei fluidum, 372 
rubi fluidum, 374 
sabina? fluidum, 377 
sarsaparilla? fluidum, 383 
sarsaparilla? compositum fluid- 
um, 309, 383 
scilla? fluidum, 385 
senega?, 387 
senega? fluidum, 387 
senna? fluidum, 388 
serpentaria? fluidum, 389 
spigelia? fluidum, 395 
spigelia? et senna? fluidum, 395 
stillingia? fluidum, 396 
stramonii foliorum, 397 
stramonii seminis, 397 
taraxaci, 403 
taraxaci fluidum, 403 
uva? ursi fluidum, 409 
Valeriana?, 410 
Valeriana? fluidum, 410 
veratri viridis liuidum, 411 
zingiberis fluidum, 415 



TMRINA tritici, 424 

JT Fel bovinum purificatum, 424 

Fennel, 258 

Fermentum, 250 



GENERAL INDEX. 



485 



Ferri bromidum, 252 

chloridum, 251 

citras, 251 

dialysatus, liquor, 430 

et ammonii citras, 128, 251 

et ammonii sulphas, 128, 251 

et ammonii tartras, 103,128,251 

et potassii tartras, 251 

et quinise citras, 251 

et strychniae citras, 251 

ferrocyanidum, 90-251 

hypophosphis, 251 

lactas, 94, 251 

oxalas, 251 

oxidum liydratum, 251 

phosphas, 251 

pyrophosphas, 251 

subcarbonas, 251 

sulphas, 251 

sulphas exsiccata, 251 

sulphuretum, 251 
Ferrum, 251 

redactum, 252 
Ficus, 257 
Fig, 257 
Filix mas, 257 
Flaxseed, 300 
Fleabane, 249 
Fleming's tincture, 105 
Flour, 424 

Fluid extract Canada spruce, 345 
Fly-blisters, 182 
Foeniculum, 258 

Form of administering drugs, 22 
Fowler's solution, 149 
Foxglove, 237 
Fusel oil, 122 



pALBANUM, 259 
U Gallae, 259 

Gamboge, 260 
Gambogia, 260 
Garlic, 122 
Gaultheria, 262 
Gelsemium, 262 
Gentian, 264 
Gentian a, 264 
Geranium, 265 
German chamomile, 308 

tea, 81 
Gin, 114 



41 



Ginger, 415 

Glauber's salt, 392 

Glycerina, 265 

Glycerine, 265 

Glycerita, 266 

Glycerites, officinal, 266 

Glyceritum acidi carbolici, 84 

acidi gallici, 259 

acidi tannici, 103, 259 

picis liquida?, 346 

sodii boratis, 392 
Glycyrrhiza, 266 
Goa powder, 425 
Goldthread, 232 
Gossypii radicis cortex, 267 
Gossypium, 267 
Goulard's cerate, 177 

extract, 347 
Granati fructus cortex, 370 

radicis cortex, 370 
Greenhow's formula for gouty 

bronchitis, 224 
Green soap, 383 
Gregory's powder, 373 
Griffith's mixture, 252 
Gross, Prof., treatment of chloro- 
form poisoning, 203 
Guaiac, 269 
Guaiaci lignum, 269 

resinse, 269 
Guaiacum, 269 
Guarana, 172 
Gum arabic, 81 
Gun cotton, 267 
Gutta percha, 269 



HABIT, doses affected by, 26 
Hsematoxylon, 270 
Halford, ammonia injection for 

snake-bites, 132 
Heart disease caused by tobacco, 
402 
croton-chloral contra-indicated 
in, 200 
Heat as a disinfectant, 57 
Hedeoma, 270 
Hellebore, white, 411 

American, 411 
Helleborus, 271 
Hemlock, 225 
spruce, 345 



486 



GENERAL INDEX. 



Hemp, American, 179 

Indian, 179 
Henbane, 284 
Hiera picra, 123, 179 
Hirudo, 439 

Hoffman's anodyne, 122 
Honey, 308 
Honeys, officinal, 308 
Hop-pillow, 272 
Hops, 271 
Hordeum, 271 
Horehound, 307 
Horsemint, 309 
Humnlus, 271 
Hnnyadi Janos water, 146 
Huxham's tincture, 221 
Hydragogue purgatives, 72 
Hydrargyri ammoniatum, 273 
Hydrargyri chloridum corrosi- 

vum, 272 
Hydrargyri chloridum mite, 272 

idiosyncrasy in regard to, 27 
Hydrargyri cyanidum, 90, 273 
Hydrargyri iodidum rubrum, 273 

viride, 273 
Hydrargyri oxidum flavum, 272 

rubrum, 272 
Hydrargyri sulphas flava, 273 

sulphuretum rubrum, 272 
Hydrargyium, 272 

ammoniatum, 128 
Hydrargyrum cum creta, 173, 

272 
Hydrastis, 283 
Hydrated lime, 173 
oxide of iron, 257 
Hydrochloric acid, 95 
Hydrocyanic acid in oil of bitter 

almonds, 133 
Hydrocyanic acid, 89 
Hydropathic treatment, 143 
Hyoscyami folia, 284 

semen, 284 
Hyoscyamia, 285 
Hyoscyamus, 284 
Hypodermic injection of apomor- 
phia, 335 

of atropia and opium, 334 

of Lugol's solution, 288 

of mercury, 281 

of morphia, 334 

of quinia, 15 



Hypodermic injection — 

of strychnia, 16, 315 
Hypodermic medication, 15 
Hypophosphite of lime, 175 



ICE for relieving pain, 144 
Iceland moss, 192 
Icthyocolla, 286 
Idiosyncrasy, 26, 27 

in regard to calomel, 27 

in regard to opium, 27 

in regard to quinine, 27 
Ignatia, 286 

Impurities of water, 141 
Incompatibilities, chemical and 

physiological, 31, 32 
Incompatibility of caustic alka- 
lies and alkaloids, 31 

of drugs, 32 

of iodide of potassium and cor- 
rosive sublimate, 31 

of iron and cinchona, 31 

of strychnia and Calabar bean, 
31 
Incompatibles of iodine, 287 
Incompatibles, special, 32 
Indian bael, 418 
Individual peculiarities, 26 
Infusa, 286 

Infusions, officinal, 286 
Infusum angusturse, 134 

anthemidis, 135 

buchu, 171 

caluinbse, 175 

capsici, 185 

caryophylli, 188 

cascarillae, 189 

catechu compositum, 190 

cinchonse flavse, 211 

cinchonse rubrse, 211 

digitalis, 237 

eupatorii, 249 

gentianse compositum, 157, 264 

humuli, 271 

juniperi, 295 

kramerise, 29b 

lini compositum, 300 

pareira, 336 

picis liquidae, 346 

pruni Virginianse, 369 

quassias, 370 






GENERAL INDEX, 



4S7 



In f us urn — 
rhei, 371 

rosse compositum, 374 

salvia, 378 

sennse, 389 

serpentarise, 389 

spigelian, 395 

tabaci, 400 

taraxaci, 403 

Valerianae, 410 

zingiberis, 415 
Inhalation, 16 

of ether, 113 
Interval between doses, 26 
Intravenous injection, 16 

of chloral, 155 
Introduction, 13 

Inunction of mercury in con- 
genital syphilis, 279, 281 
Iodine, 287 
Iodinium, 287 
Iodism, 367 

to prevent, 22 
Iodoform, 289 
Iodoformum, 289 
Ipecacuanha, 289 

toleration of, in dysentery, 29 
Irish moss, 210 
Iron, 251 
Isinglass, 286 

JABORANDI, 425 
Jalap, 294 
Jalapa, 294 
James's powder, 139 
Jamestown weed, 396 
Jervia, 413 
Johnson, Dr. Geo., treatment of 

diarrhoea, 322 
Juglans, 295 
Juices, officinal, 225 
Juniper, 295 
Juniperus, 295 

KAMALA, 431 
Kermes mineral, 136 
Kinic acid, 220 
Kino, 296 
Kinovin, 220 
Kousso, 421 
Krameria, 297 



LABARRAQUE'S solution, 393 
Lactate of iron, 94 
Lactic acid, 94 

Lactophosphate of lime and cod- 
liver oil, 320 
Lactucarium, 296 
Larch-bark, 431 
Lard, 110 
Laricis cortex, 431 
Laudanum, 325 

in infancy, 34 
Laughing-gas, 433 
Laurocerasi folia, 432 
Lavandula, 298 
Lavender, 298 
Laxative effects of water, 

144 
Laxatives, 71 
Lead, 347 

in drinking-water, 145 

plaster, 347 

water, 347 
Ledoyen's disinfecting solution, 

347 
Leeches, 439 
Lemon, 298 

juice, 298 
Leptandra, 298 
Lettuce-opium, 296 
Licorice, 266 
Lime, 173 

water, 173 
Limones, 298 
Limonis cortex, 298 

succus, 298 
Lini farina, 300 
Linimenta, 300 
Liniments, officinal, 300 
Linimentum aconiti, 105 

ammonia?, 128 

calcis, 174, 300 

camphorse, 176 

cantharidis, 181 

chloroformi, 203 

plumbi subacetatis, 347 

saponis, 177, 382 

terebinthinse, 404 
Linseed meal, 300 

oil, 300 
Linum, 300 
Liquor ammonii acetatis, 128 

arsenici chloridi, 149 



488 



GENERAL INDEX. 



Liquor — 

arsenici et hvdrargyri iodidi, 
149, 273, 287 

barii chloridum, 158 

calcii chloridi, 174 

calcis, 174 

ferri chloridi, 251 

ferri citratis, 251 

ferri dialysatus, 430 

ferri nitratis, 252 

ferri subsulphatis, 252 

ferri tersulphatis, 252 

gutta-perchae, 269 

hydrargyri nitratis, 273 

iodinii compositus, 287 

magnesii citratis, 304 

morphise sulphatis, 326 

plumbi subacetatis, 347 

plumbi subacetatis dilutus, 
347 

potassae, 352 

potassii arsenitis, 149, 352 

potassii citratis, 353 

potassii permanganatis, 353 

soda?, 392 

sodae chlorinatae, 393 

sodii arseniatis, 149, 392 

zinci chloridi, 413 
Liquores, 304 
Liquors, officinal, 304 
Lister's antiseptic system, 86 
Lithii carbonas, 301 

citras, 301 
Lithium, 301 
Lobelia, 302 
Logwood, 270 
Lugol's solution, 287 
Lupulina, 271 
Lycopodium, 304 



MACE, 311 
Maris, 311 
Magnesia, 304 
Magnesii carbonas, 304 

sulphas, 304 
Magnesium, 304 
Male fern, 257 
Malt extract, 271 
Manganese, 306 
Manganesii oxidum nigrum, 306 

sulphas, 306 



Manganesium, 306 

Manna, 306 

Maranta, 307 

Marble, 307 

Marjoram, 335 

Marmor, 307 

Marrubium, 307 

Marshmallow, 125 

Marsh-rosemary, 396 

Marsh's test for arsenic, 151 

Mastic, 307 

Mastiche, 307 

Materia medica, primary list of, 

81 
Matico, 307 
Matricaria, 308 
May-apple, 351 
Meconine, 335 
Mel, 308 

despumatum, 308 

rosae, 374 

sodii boratis, 392 
Mellita, 308 
Mentha piperitae, 309 

viridis, 309 
Mercurial baths in syphilis, 279, 
281 

fumigation, 281 
Mercurialization, 280 
Mercury, 272 
Methyl conia, 226 
Metric system, 455 

in medicine, 43, 458 
Mezereon, 309 
Mezereum, 309 
Milk of almonds, 133 

of ammoniac, 127 

of assafetida, 155 
Mineral waters, 145 
Misturae, 310 
Mistura ammoniaci, 127 

amygdalae, 133 

assafcetidae, 155 

chloroformi, 177, 202 

cretae, 173 

ferri composita, 252 

glycyrrhizae composita, 266 

potassii citratis, 298 
Mixtures, officinal, 310 
Molasses, 377 
Monarda, 310 
Mori succus, 431 






GENERAL INDEX. 



489 



Morphia, 326 
Morphia? acetas, 326 

murias, 326 

sulphas, 326 
Moschus, 310 
Mucilages, officinal, 310 
Mucilagines, 310 
Mucilago acacise, 81 

sassafras medullar, 384 

tragacanthse, 408 

ulmi, 408 
Mulberry juice, 431 
Muriatic acid, 95 
Musk, 310 
Mustard, 390 

poultice, how to make, 391 
Mydriasis by belladonna, 161 

by hyoscyamus, 284 
Myristica, 311 
Myrrh, 311 
Myrrha, 311 



YTARCEIA, 335 

xi Narcotics and Anodynes, 

68 
Narcotics, 68 
Narcotina, 335 
Nectandra, 313 
Neroli water, 157 
Nicotia, 402 
Nitric acid, 97 
Nitrite of amyl, 417 
Nitroglycerin, 432 
Nitroglycerinum, 432 
Nitro-muriatic acid, 98 
Nitrous oxide gas, 433 
Norwood's, Dr., tincture of ve- 

ratrum viride, 411 
Nutgall, 259 
Nutmeg, 311 
Nux vomica, 313 



AAK, 371 

\f Oat-meal, 157 

Oil of almonds, expressed, 133 

of amber, 322 

of American pennyroyal, 270 

of anise, 135 

of bergamot, 169 



Oil— 

of bitter almonds, 133 

of cajuput, 173 

of camphor, 176 

of Canada fleabane, 249 

of castor, 321 

of chamomile, 135 

of cinnamon, 221 

of cloves, 188 

of cod-liver, 317 

of copaiva, 229 

of croton, 323 

of cubebs, 234 

of fennel, 258 

of gaultheria, 262 

of horse-mint, 310 

of juniper, 295 

of lavander, 298 

of lemon, 298 

of linseed, 300 

of neroli, 157 

of nutmeg, 311 

of olive, 321 

of orange, 157 

of origanum, 335 

of peppermint, 309 

of pimento, 344 

of rose, 373 

of rosemary, 374 

of rue, 375 

of savin, 403 

of sassafras, 384 

of spearmint, 309 

of spruce, 345 

of sweet almonds, 403 

of tobacco, 400 

of turpentine, 404 

of theobroma, 323 

of thyme, 323 

of valerian, 410 

of wormseed, 192 
Oils, officinal, 317 
Ointments, 409 
Olea, 317 
Oleo-resinae, 371 
Oleo-resina capsici, 185 

cubeba?, 233 

filicis, 257 

lupulinse, 271 

piperis, 345 

zingiberis, 415 
Oleo-resins, officinal, 371 



490 



GENERAL INDEX. 



Oleum sethereum, 317 

amygdalse am arse, i 33 

amygdalse expressum, 133 

anisi, 135 

anthemidis, 135 

bergamii, 169 

cajuputi, 173 

camphorse, 176 

cari, 188 

caryophilli, 188 

clienopodii, 192 

cinnamomi, 221 

copaibse, 229 

cubebse, 234 

erigerontis Canadensis, 249 

fceniculi, 258 

gaultherise, 262 

liedeomse, 270 

juniperi, 295 

lavandulse, 298 

limonis, 298 

lini, 300 

menthse piperitse, 309 

menthse viridis, 309 

monardse, 310 

morrliuse, 317 

myristicse, 311 

olivse, 321 

origani, 335 

pimentse, 344 

ricini, 321 

rosse, 373 

rosmarini, 374 

rutse, 375 

sabinse, 377 

sassafras, 384 

succini, 322 

succini rectificatum, 322 

tabaci, 400 

terebintliinse, 404 

theobromse, 323 

thyrui, 323 

tiglii, 323 

valerianse, 410 
Olive oil, 321 
Opium, 325 

effect on rabbits of, 40 

idiosyncrasy in regard to, 29 

in childhood, 34 
Opodeldoc, 323 
Orange, 156 

flowers, 156 



Orange-peel, bitter, 156 

sweet, 156 
Orgeat syrup, 157 
Origanum, 335 
Os, 336 
Ovum, 336 

Oxalate of cerium, 191 
Oxalic acid, 99 
Ox-bile, 424 
Oxymel, 84 
Oyster-shell, 407 

prepared, 407 



PAIN relieved by counter-irri- 
tants, 59 
Painters' colic, 349 
Papaver, 336 
Papaverina, 335 
Paramorphia, 335 
Paraplegia, alcoholic, 116 
Parasiticides, 51 
Paregoric, 325 
Pareira, 336 

brava, 336 
Parsley, 434 
Partridge-berry, 262 
Pearl-ash, 352 
Peculiarities, individual, 26 
Pennyroyal, American, 270 
Pepo, 337 
Pepper, 345 
Peppermint, 309 
Pepsin, 433 
Pepsina porci, 433 
Peruvian bark, 210 
Petroselinum, 434 
Phosphoric acid, 99 
Phosphorus, 337 
Physiological antidotes, 53 
Physiology of vomiting, 64 
Physostigma, 341 
Pill, Guy's, 282 

Plummer's. 272 
Pills, officinal, 344 
Pilocarpia, 425 
Pilula ferri carbon atis, 252 

saponis composita, 325, 382 
Pilulse, 344 

aloes, 123 

aloes et assafoetidse, 123, 156 

aloes et mastiches, 123 



GENERAL INDEX. 



491 



Pilule— 

aloes et myrrhae, 123, 311 

antimonii compositae, 136, 272 

assafoetidae, 156 

catharticae compositae, 224, 272 

copaiba?, 229 

ferri compositae, 252 

ferri iodidi, 252, 287 

galbani compositae, 156, 259 

hydrargyri, 272 

opii, 325 

quinise sulphatis, 211 

rhei, 371 

rhei compositae, 123, 371 

scillae compositae, 127, 385 
Pimenta, 344 
Pimento, 344, 
Pinkroot, 395 
Pinus Canadensis, 345 
Pinus palustris, 346 
Piper, 345 
Piperin, 345 
Pipsissewa, 192 
Pix Burgundica, 345 

Canadensis, 345 

liquida, 346 
Plaster, warming, 181 
Plasters, officinal. 244 
Plumbi acetas, 347 

carbonas, 347 

iodidum, 347 

nitras, 347 

oxidum, 347 
Plumbum, 347 
Podophyllin, 351 
Podophyllum, 351 
Poisoning, 51, 441 (see Index of 
Diseases and Table of Poi- 
sons) 

by acids, 48 

by aconite, 105 

by alcohol, 115 

by ammonia, 128 

by amylic alcohol, 122 

by antimony, 136 

by arsenic, 149, 150 

by barium, 158 

by belladonna, 166 

by bichromate of potassium, 
359 

by bitter almonds, 134 

by cantharides, 181 



Poisoning — 

by carbolic acid, 85 

by chloral, 193, 196 

by chloroform, 203, 206 

by copper, 234 

by corrosive sublimate, 273 

by digitalis, 237 

by hemlock, 228 

by hydrocyanic acid, 90, 93 

by lead, 347 

by muriatic acid, 95 

by opium, 326 

by oxalic acid, 99 

by poison-oak, 171 

by phosphorus, 340 

by physostigma, 344 

by potassa, 354 

by santonin, 382 

by soda, 393 

by strychnia, 313 

by sulphuric acid, 100 

by tartar emetic, 136 

by tartaric acid, 103 

by tobacco, 401 

by veratria, 375 

vegetable, 444 
Poisons, 440 

table of, 441 

tests for, 446 
Pomegranate, 370 
Poppy capsules, 336 
Port wine, 114 
Potassa, 352 
Potassa-alum, 352 
Potassa cum calce, 174, 352 

with lime, 352 
Potassii acetas, 352 

bicarbonas, 3.52 

bichromas, 352, 359 

bitartras, 352 

bromidum, 170, 353, 360 

carbonas, 353 

carbonas impura, 353 
pura, 353 

chloras, 353 

citras, 353 

cyanidum, 90, 353 A 

et sodii tartras, 354 

ferrocyanidum, 90, 252, 353 

hypophosphis, 353 

iodidum, 353, 36-1 

nitras, 353 



492 



GENERAL INDEX. 



Potassii — 

permanganas, 353 

sulphas, 353 

sulphis, 353, 398 

sulphnretum, 354 

tartras, 354 
Potassium, 352 
Potassium bromide, 360 
Powders, officinal, 369 
Precipitated carbonate of lime, 
173 

phosphate of lime, 173 
Prepared chalk, 173 
Prescribing, rules for, 19 

for children, 33 
Prescription writing, 36 
Prescriptions, for combining : 

alum, 126 

arsenic, 155 

ammonium, acetate of, 133 
carbonate of, 132 
chloride of, 133 

benzoin, 168 

bismuth, 170 

carbolic acid, 86 

capsicum, 185 

castor oil, 322 

catechu, 190 

cerium, oxalate of, 191 

chloral, 199 

cod-liver oil, 320 

colchicum, 223 

columbo, 176 

copaiva, 231, 232 

conia (hypodermic), 229 

croton oil, 325 

digitalis, 243 

ergot, 248 

fern-oil, 258 

gallic acid, 260 

garlic, syrup of, 123 

hsematoxylon, 270 

hydrocyanic acid, 94 

hyoscyamus, 284, 285 

hyoscyamia, 285 

Indian hemp, 181 

iron, 257 

juniper, 296 

liquor ainmonii acetatis, 133 

magnesia, 306 

male fern, 258 

mercury, 282 



Prescriptions, for combining — 

myrrh, 313 

nitric acid, 98 

nitro-muriatic acid, 98 

oil of amber, 323 

opium, 333 

podophyllin, 352 

potash salts, 359 

potassium, bromide of, 363 
iodide of, 369 

quinia. 218, 219 

rhubarb, 373 

salicylic acid, 438 

scoparius, 387 

senega, 388 

soda, 394 

sodium, salicylate of, 438 

strychnia, 316 

sulphuric acid, 102 

taraxacum, 404 

tartar emetic, 140 

thymol, 438 

turpentine, 406 

zinc salts, 415 
Prescriptions, how to write, 19, 

36 
Proper time for exhibiting drugs, 

22 
Prunes, 369 
Prunum, 369 
Prunus Virginianse, 369 
Prussian blue, 251 
Pulveres, 369 

effervescentes, 103 

effesvescentes aperientes, 103 
Pulvis aloes et canellae, 23, 179 

aromaticus, 187, 221 

ipecacuanhse comp., 289 

jalapse compositus, 294 

rhei compositus, 372 
Pumpkin-seeds, 337 
Punica granatum, 370 
Purgatives, action of, 70 

classes of, 70 

combination of, 23 

for children, 34 

when to be given, 23 
Purging cassia, 189 
Purified aloes, 123 

ox-bile, 424 
Pyroxylon, 267 



GENERAL INDEX. 



493 



QUASSIA, 370 
Queen's root, 396 
Quercus alba, 371 

tinctoria, 371 
Questions, 447 
Quicklime, 173 
Quinia, administration of, 21S 

idiosyncrasy in regard to, 27 

sulphas, 211 

valerianas, 104, 122 
Quinic acid, 220 
Quinidia, 220 
Quino-tannic acid, 220 



RAISINS, 409 
Red saunders, 379 
Refrigerants, antipyretics and, 53 
Reinsch's test for arsenic, 140 
Remedies, certain classes of, 45 

officinal, x 
Resin, 371 
Resina, 371 

jalapse, 294 

podophylli, 351 

scammonii, 384 
Resinse, 371 
Resins, officinal, 371 
Rliamni succus, 434 
Rhatany, 297 
Rheum, 372 

Rheumatism, pathology of, 95 
Rhubarb, 372 
Rochelle salt, 354 
Rosa centifolia, 373 

gallica, 373 
Rose, 373 
Rosemary, 374 
Rosmarinus, 374 
Rottlera, 431 
Routes by which medicines enter 

the circulation, 14 
Rubus, 374 
Rue, 375 

Rules for prescribing, 19 
Ruta, 375 



QABADILLA, 375 
U Sabina, 377 
Saccharum, 378 
lactis. 378 
42 



Saffron, 233 
Sage, 376 
Sago, 378 
Salicin, 434 
Salicylic acid, 435 
Saline purgatives, 72 

waters, 145 
Salivation, mercurial, 280 
Salvia, 378 
Sambucus, 378 
Sanguinaria, 379 
Sanguis uga officinalis, 439 
Santalum, 379 
Santonica, 379 
Santoninum, 379 
Sapo, 382 

viridis, 383 
Saratoga water, 145 
Sarsaparilla, 383 
Sassafras, 384 

medulla, 384 
Savine, 377 
Scammonium, 384 
Scammony, 384 
Scheele's solution, 89 
Scilla, 385 
Scoparius, 386 
Scudamore's mixture, 224 
Seidlitz powders, 393, 394 
Seltzer water, 145 
Senega, 387 
Seneka, 387 
Senna, 388 

American, 189 
Serpentaria, 389 
Sevum, 390 
Sherry wine, 114 
Silver, 146 

cyanide of, 146 

fused nitrate of, 147 

in surgery, 147 

nitrate of, 146 

oxide of, 147 

pills of nitrate of, liable to ex- 
plode, 147 

toleration of, 148 
Sinapis alba, 390 

nigra, 390 
Skin-discoloration from silver 

salts, 148 
Slippery-elm, 408 
Snakeroot, 389 



494 



GENERAL INDEX. 



Soap, 382 

Socotrine aloes, 123 
Soda, 392 

mint, 394 
Soda powders, 103 
Sodii acetas, 392 

arsenias, 149, 392 

bicarbonas, 393 

bicarbonas venalis, 392 

boras, 392 

carbonas, 392 

carbonas exsiccata, 393 

chloridum, 392 

hypophosphis, 392 

hyposulphis, 392, 398 

nitras, 392 

phosphas, 392 

salicylas, 435 

sulphas, 392 

sulphis, 392, 398 
Sodium, 392 

Solution of acetate of ammo- 
nium, 128 

dialyzed iron, 430 

of arseniate of sodium, 149 

of arsenite of potassium, 352 

of chloride of arsenic, 149 

of chloride of barium, 158 

of chloride of lime, 174 

of iodide of arsenic and mer- 
cury, 149, 273, 287 

of lime, 174 

of nitrate of iron, 252 

of nitrate of mercury, 273 

of permanganate of potassium, 
353 

of persulphate of iron, 252 

of potassa, 252 

of soda, 392 

of subacetate of lead, 347 

of subsulphate of iron, 252 

of sulphate of morphia, 326 

of tersulphate of iron, 252 
Solution, Monsel's, 252 
Spanish-fly, 181 
Spearmint, 309 
Specific action of quinia, 216 
Spermaceti, 191 

cerate, 191 
Spigelia, 395 
Spirit of ammonia, 128 

of ammonia, aromatic, 128 



Spirit — 

of camphor, 177 
Spirits, officinal, 395 
Spiritus aetheris compositus, 111, 
121 

a?theris nitrosi, 122 

ammonia?, 128 

ammonia? aromaticus, 128, 132, 
298 

anisi, 135 

camphor a?, 177 

chloroformi, 202 

cinnamomi. 221 

frumeiiti. 114, 395 

Geneva?, 114 

juniperi, 295 

juniper! compositus, 114, 295 

lavandula?, 298 

lavandula? compositus, 298 

limonis, 298 

mentha? piperita?, 309 

mentha? viridis, 309 

myrcia?, 114, 395 

myristica?, 311 

saponis kalinis, 383 

vini Gallici, 114, 396 
Spurred rye, 245 
Squill, 385 
Starch, 134 

of canna, 179 
Statice, 396 
Stillingia, 396 
Stimulants, alcoholic, 115 
Stimulants and sedatives, 73 
Stomach-pump, caution in regard 

to, 52 
Storax, 397 
Stramonii folia, 396 
Stramonii semen, 396 
Stramonium, 396 
Strong alcohol, 114 
Stronger aether, 111 
Strychnia, 313 

eaten by pigeons, 40 

hints on prescribing, 30 

injections, 315 
Strychnia? sulphas, 313 
Strychnos ignatia, 313 

nux vomica, 313 
Styrax, 397 

Styria, arsenic eating in, 28, 153 
Succi, 225, 397 






GENERAL INDEX. 



495 



Succus conii, 225 

taraxaci, 403 
Suet, 390 
Sugar, 377 

of lead, 347 

milk, 378 
Sulphate of atropia, 159 

of morphia, 326 
Sulphur, 397 

lotum, 397 

pnecipitatum, 398 

suhlimatum, 397 
Sulphurated antimony, 136 
Sulphuret of antimony, 135 
Sulphuretted waters, 145 
Sulphuric acid, 100 
Sulphuris iodidum, 398 
Sulphurous acid, 102 
Sumbul, 438 
Summary of Action of Drugs, 

79 
Suppositoria, 323, 400 

acidi carbolici, 84 

acidi tannici, 103, 259 

aloes, 124 

assafoetida?, 156 

belladonna?, 159 

morphise, 326 

opii, 325 

plumbi, 347 

plumbi et opii, 325, 347 
Suppositories, 17, 323 

aloes, 95 

assafoetida, 156 

belladonna, 159 

carbolic acid, 84 

officinal, 400 
Sweet almond, 133 
Sweet spirit of nitre, 122 
Syrup, orgeat, 157 
Syrupi, 400 
Syrups, officinal, 400 
Syrupus, 378 

acacia?, 81 

acidi citrici, 88, 298 

allii, 122 

amygdalae, 134 

aurantii cortiois, 157 
florum, 157 

ferri iodidi, 252, 287 

fuscus, 377 

ipecacuanha?, 289 



Syrupus — 

kramerise, 296 
lactucarii, 297 
limonis, 298 
papaveris, 336 
pruni Virginianae, 369 
rhei, 372 

aromaticus, 372 
rosa? Gallica?, 374 
rubi, 374 

sarsaparilla? compositum, 383 
scillae, 385 

compositns, 136, 385 
senega?, 387 
tolutanus, 158 
zingiberis, 416 



TABACUM, 400 
Table-salt, 392 
Taenia?, varieties of, 49 
Tamarind, 403 
Tamarindus, 403 
Tannic acid, 103 
Tapioca, 403 
Tar, 346 
Taraxacum, 403 
Tartar emetic, 1 35 
Tartaric acid, 103 
Tartrate of antimony and potas- 
sium, 135 

of iron and ammonia, 135 
Tea, 172 
Tea-berry, 262 
Temperature reduced by baths, 

142 
Terebinthina, 404 

Canadensis, 404 
Testa, 407 

praeparata, 173, 407 
Tests for alcohol, 114 

antimony, 136 

arsenic, 151 

atropia, 446 

barium, 159 

brucia, 314, 446 

conia, 226 

copper, 234 

sulphate of, 236 

delphinia, 446 

emetia, 446 

hydrocyanic acid, 90 



496 



GENERAL INDEX. 



Tests for — 

mercury, 274 

morphia, 446 

muriatic acid, 97 

oxalic acid, 99 

potassium, 334 

potassii bichromas, 360 

soda, 393 

solanium, 446 

strychnia, 314, 446 

sulphuric acid, 100 

tannic acid, 103 

tartaric acid, 104 

veratria, 446 
Tetanus from hypodermic injec- 
tion, 15 
Thebaia, 335 
Theobroma, 323 

Therapeutic deductions from 
physiological experiments, 
40* 
Thieves' vinegar, 81 
Thymol, 438 
Thoroughwort, 249 
Time for exhibiting medicines, 22 
Tincturae, 407 
Tinctura aconiti radicis, 105 

aloes, 123 

aloes et myrrhae, 123, 311 

arnicas, 148 

assafcetidas, 155 

aurantii, 157 

belladonnas, 159 

benzoini, 168 

benzoini composita, 123, 158, 
168 

calunibas, 175 

cannabis, 179 

cantharidis, 181 

capsici, 185 

cardamomi, 188 
composita, 188 

castorei, 189 

catechu, 190 

cinchonas, 211 

composita, 157, 211 

cinnamomi, 221 

colchici, 222 

conii, 226 

cubebas, 234 

digitalis, 237 

ferri chloridi, 252 



Tinctura — 

gallas, 259 

gentianas composita, 157, 188, 
264 

guaiaci, 264 

guaiaci ammoniata, 128, 269 

hellebori, 271 

humuli, 271 

hyoscyami, 284 

iodinii, 286 

iodinii composita, 286 

jalapas, 294 

kino, 296 

krameriae, 296 

lobelias, 302 

lupulinse, 271 

myrrhas, 311 

nucis vomicas, 313 

opii, 325 

opii acetata, 325 

opii camphorata, 177, 325 

opii deodorata, 325 

quassias, 370 

rhei, 188, 372 

rhei et sennas, 372, 389 

sanguinarias, 379 

scillas, 385 

serpentarias, 390 

stramonii, 397 

tolatana, 158 

Valerianae, 410 

Valerianae ammoniata, 128, 410 

veratri viridis, 411 

zingiberis, 416 
Tincture of gelsemium, 262 
Tinctures, officinal, 407 
Tobacco, 400 
Tolerance of antimony, 29, 138 

of opium, 332 

of quinia, 214 

of zinc sulphate, 415 
Toleration of drugs, 29 
Tonics, 75 
Tragacanth, 408 
Tragacantha, 408 
Treatment of poisoning (see An- 
tidote and Index of Diseases) 
Trimethylamine, 439 

hydrochlorate of, 439 
Troches, officinal, 408 
Trochisi, 408 

acidi tannici, 103, 259 



GENERAL INDEX. 



497 



Trocliisci — 

cr^tse, 173 

cubebse, 234 

ferri subcarbonatis, 252 

glycyrrhizae et opii, 266, 326 

ipecacuanha?, 289 

magnesia?, 304 

menthse piperita?, 309 

morphia? et ipecacuanha?, 289, 
326 

potassii chloratis, 353 

santonini, 379 

sodii bicarbonatis, 393 

zingiber] s, 416 
Turmeric, 423 
Turpentine, 404 
Turpetli mineral, 273 
Typhoid fever propagated by 
water, 144 



ULMUS, 408 
Unguenta, 409 
Unguentum, 110 
acidi carbolici, 84 
acidi tannici, 103 
antimonii, 259 
aqua? rosa?, 134, 374 
belladonna?, 159 
benzoini, 168 
cantharidis, 181 
creasoti, 233 
galla?, 259 
hydrargyri, 272 
hydrargyri ammoniati, 273 
hydrargyri iodidi rubri, 273 
hydrargyri nitratis, 273 
hydrargyri oxidi flava?, 272 
hydragyri oxidi rubri, 272 
iodinit, 287 

iodinii corapositum, 287 
mezerei, 309 
picis liquida?, 346 
plumbi carbonatis, 347 
plumbi iodidi, 347 
potassii iodidi, 297 
stramonii, 397 
sulphuris, 398 
sulphuris iodidi, 398 
tabaci, 400 
veratrise, 375 
zinci oxidi, 413 
43 



Uva passa, 409 
Uva ursi, 409 



VALERIAN, 410 
Valerianate of ammonia, 104 
Valerianic acid, 104, 410 
Vallet's mass, 252 
Vanilla, 411 
Veratralbia, 411 
Veratria, 375 
Veratroidia, 413 
Veratrum album, 411 

viride, 411 
Verdigris, 234 
Vienna paste, 352 
Vina, 413 
Vinegar, 82 
Vinum aloes, 124, 188 

antimonii, 136 

colchici radicis, 222 

colchici seminis, 222 

ergota?, 245 

ipecacuanha?, 289 

opii, 326 

Portense, 114 

rhei, 179, 372 

tabaci, 400 

Xericum, 114 
Virginia snake-root, 389 
Virginia Sulphur Springs, 146 
Vomiting, physiology of, 64 

therapeutics of, 64 

WARBURG'S tincture, 220 
Warm bath in children's 
complaints, 143 
Warner's gout cordial, 389 
Water, 141 

ammonia, 128 

ammonia, stronger, 128 

anise, 135 

bitter almond, 135 

camphor, 176 

classificationofnatural,141,145 

hard and soft, 141 

orange-flower, 157 
Wax, 191 

white and yellow, 191 
Weights and measures, 37, 454 
Wheat flour, 424 
Whiskey, 395 



498 



GENERAL INDEX. 



Wild cheny, 369 
Wines, officinal, 413 
Wintergreen, 193 
Wistar's cough lozenges, 326 
Woorara, 422 
Woruiseed, 192 
Wormwood, 81 
Wrist-drop, 350 



yEAST, 250 
1 Yellow jasmine, 262 



yiNC, 413 

/J Zinci acetas, 413 

carbon as prsecipitata, 413 

chloridum, 413 

oxidnm, 413 

oxidum venale, 413 

sulphas, 413 

sulphas, toleration of, 415 

valerianas, 104, 413 
Zincum, 413 
Zingiber, 415 
Zittmann's decoction, 283 






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Bt ALFRED STILLE, M.D., LL.D., 

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this work, on account of its conciseness, is adapted to the pharmacal student, 
it is equally adapted to the medical student aud practitioner by its well arranged 
therapeutical index, containing about 3750 references, while the materia medica 
index embraces about 10,400. The physician sees at a glance all medicines that 
are used for any certain class of diseases. — Chicago Pha-macist and Chtmist, 
April, 1S79. 

The therapeutic part is as rich as would be expected of the author of the most 
comprehensive work on the subject in our language. The physiological effects 
of drugs receive due attention, and their influence over disease is stated succinctly. 
For the task of winnowiug theimmense accumulation of periodical literature, the 
experience and matured judgment uf Prof. Stille were eminently fitted. No phar- 
macist or doctor will repent the purchase of a book which is at ODce a treasury of 
facts and the digest of a decision of a high court. — Louisville Med. Ntics, March 
29, 1S79. 

The pharmaceutical world has for a long time been on the qui vive, in expecta- 
tion of the forthcoming Dispensatory by Profs. Stille & Maisch, who have acquired 
such a reputation in their respective departments that nothing but a satisfactory 
work could be expected; this expectation has been quite realized. We have 
examined the work with some care, and are very much pleased that we can 
pronounce it to be reliable, comprehensive, and including the latest researches 
available to its authors. Thisis more particularly true as regards the portion de- 
voted to pharmaceutical subjects. We are fully justified in stating that it is, 
taken altogether, one of the most important and creditable publications which 
have of late been issued by the American press. It will be an indispensable 
reference book both for the pharmacist aud the physician. — New Remedies, April, 
1S79. 

A careful examination of the work calls forth unqualified praise for its excellent 
arrangement, full yet concise information, its careful adherence to the best au- 
thority on each particular topic, as well as the entire elimination of all unne- 
cessary and obsolete data and particulars. The arrangement of all topics is 
purely alphabetical, and with surprising fidelity to the wants both of the phy- 
sician and pharmaceutist. New remedies which have come into recent use are 
here found noticed, with such facts as have been collated from careful investi- 
gation. — Druggists' Circular and Chemical Gazette, March, 1S79. 

The reputation of Prof. Stille is national. What he undertakes to do, he will 
do, and in the present work we are not disappointed. The National is a com- 
plete consecutive volume. The topics arranged in alphabetical order, afford all 
the desired information in regard to each drug; its properties, action, therapeu- 
tic impoitance. Each drug has its pharmaceutic preparations and proper doses. 
In a word, the National Dispensatory is complete, both as a dispensatory and 
materia medica. — The Obstetric Gazette, April, 1S79. 

This is a most magnificent woi'k, with its over sixteen hundred closely printed 
pages and two hundred illustrations. As should bein a Dispensatory, the alpha- 
betical order of arrangement has been adopted throughout But it would require 
several pages of the Medical News for us to give even briefly a description of 
the work. Prof. Stille's work on Materia Medica and Therapeutics has ever since 
its publication been a standard work on those subjects, and this fact alone is 
certainly a guarantee of his qualifications for the important work of producing a 
Dispensatory; and as regards Professor Maisch, his h ; gh standing as a chemist 
and pharmaceutist is well known. We would probably ma l e an importaut 
omission in our brief notice of the work if we failed to draw attention to a feature 
quite novel in a Dispensatory, namely, the possession of a Therapeutical Index. 
By reference to it the physician cau see at a glance the remedies usually em- 
ployed in any disease. The Iudex of Materia Medica coders fifty- five triple 
columned pages, and contains about 10,400 references. The Therapeutical Index 
occupies thirty-three double columned pages, and contains about 37o0 refe- 
rences.— Cincinnati Med. News, March, 1879. 



HENRY C. LEA-Philadelphia. 



CATALOGUE OF BOOKS 

PUBLISHED BY 

ih: is isr :e=l ~5r o. i_.im.A_. 

(LATE LEA & BLANCHARD.) 



The books in the annexed list will be sent by mail, post-paid, to any 
Post Office in the United States, on receipt of the printed prices. No 
risks of the mail, however, are assumed, either on money or books. Gen- 
tlemen will therefore, in most cases, find it more convenient to deal with 
the nearest bookseller. 

Detailed catalogues furnished or sent free by mail on application. An 
illustrated catalogue of 64 octavo pages, handsomely printed, mailed on 
receipt of 10 cents. Address, 

HENRY C. LEA, 

Nos. 706 and 708 Sansom Street, Philadelphia. 



PERIODICALS, 
Free of Postage. 



A 



MERICAN JOURNAL OF THE MEDICAL SCIENCES. 1 F 

Edited by Isaac Hays, M.D., published quarterly, about I n ° r 

1100 large 8vo. pages per annum, \ • L ' ollars Per 

MEDICAL NEWS AND LIBRARY, monthly, 384 large . ai * num » 
o ° / in advance. 

8vo. pages per annum, J 

OR, 

AMERICAN JOURNAL OF THE MEDICAL SCIENCES, 1 
Quarterly, ! For six 

MEDICAL NEWS AND LIBRARY, monthly, [ Dollars per 

MONTHLY ABSTRACT OF MEDICAL SCIENCE, 48 | annum, 

pages per month, or nearly 600 pages per annum. \ in advance. 

In all, about 2100 large 8vo. pages per annum, J 

TWTEDICAL NEWS AND LIBRARY, monthly, in advance, $1 00. 
TUTONTHLY ABSTRACT OF MEDICAL SCIENCE, in advance, $2 50. 

OBSTETRICAL JOURNAL. With an American Supplement, edited 
by J. V. Ingham, M. D. $5 00 per annum, in advance. Single 
Numbers, 50 cents. Is published monthly, each number containing 
ninety-six octavo pages. 



2 HENRY C. LEA'S PUBLICATIONS. 

ALLEN (HARRISON). A SYSTEM OF HUMAN ANATOMY. 
WITH AN INTRODUCTORY CHAPTER ON HISTOLOGY, by 
E. 0. Shakespeare, M.D. In one large and handsome quarto vol., 
with numerous wood-cuts, and several hundred original illustrations 
on lithographic plates. {Preparing.) 

ASHTON (T. J.) ON THE DISEASES, INJURIES, AND MALFOR. 
MATIONS OF THE RECTUM AND ANUS. With remarks on 
Habitual Constipation. Second American from the fourth London 
edition, with illustrations. 1 vol. 8vo. of about 300 pp. Cloth, $3 25. 

ASHWELL (SAMUEL). A PRACTICAL TREATISE ON THE DIS- 
EASES OF WOMEN. Third American from the third London edi- 
tion. In one 8vo. vol. of 528 pages. Cloth, $3 50. 

ASHHURST (JOHN, Jr.) THE PRINCIPLES AND PRACTICE OF 
SURGERY. FOR THE USE OF STUDENTS AND PRACTI- 
TIONERS. Second and revised edition. In 1 large 8vo. vol. of 
over 1000 pages, containing 542 wood-cuts. Cloth, $6 00; leather, 
$7 00. (Now ready.) 

ATTFIELD (JOHN). CHEMISTRY; GENERAL, MEDICAL, AND 
PHARMACEUTICAL. Eighth edition, revised by the author. In 
1 vol. 12mo. of 700 pages, with 87 illustrations. Cloth, $2.50 ; leather, 
$3.00. {Now ready.) 

BROWNE (LENNOX). THE THROAT AND ITS DISEASES. With 
one hundred illustrations in color and fifty wood-cuts. In one hand- 
some imp. 8vo. vol., cloth, $500. (Just issued.) 
BROWNE (EDGAR A.) HOW TO USE THE OPHTHALMOSCOPE. 
Elementary instruction in Ophthalmoscopy for the Use of Students. 
In one small 12mo. vol , many illust. Cloth, $1. (Just issued.) 

BLOXAM (C. L.) CHEMISTRY, INORGANIC AND ORGANIC. 
With Experiments. In one handsome octavo volume of 700 pages, 
with 300 illustrations. Cloth, $4 00 ; leather, $5 00. 

BRINTON (WILLIAM). LECTURES ON THE DISEASES OF THE 
STOMACH. From the second London ed. 1 vol. 8vo. Cloth, $3 25. 

BASHAM (W. R.) RENAL DISEASES; A CLINICAL GUIDE TO 
THEIR DIAGNOSIS AND TREATMENT. With illustrations. 
1 vol. 12mo. Cloth, $2 00. 

BTJMSTEAD (F. J.) THE PATHOLOGY AND TREATMENT OF 
VENEREAL DISEASES. Third edition, revised and enlarged, with 
illustrations. 1 vol. 8vo.. of over 700 pages. Cloth, $5 ; leather, $6. 
AHD CULLERIER'S ATLAS OF VENEREAL. See"CtJLLERiER." 

BARLOW (GEORGE H.) A MANUAL OF THE PRACTICE OF 
MEDICINE. 1 vol. 8vo., of over 600 pages. Cloth, $2 50. 

BRISTOWE (JOHN SYER). A MANUAL OF THE PRACTICE OF 
MEDICINE. A new. work, edited with additions by James H. 
Hutchinson, M.D. In one handsome 8vo. volume of over 1100 
pages. Cloth, $5 50; leather, $6 50. (Lately issued .) 

BOWMAN (JOHN E.) A PRACTICAL HAND-BOOK OF MEDICAL 
CHEMISTRY. Sixth American, from the fourth London edition. 
With numerous illustrations. 1 vol. 12mo. of 350 pp. Cloth, $2 25. 
INTRODUCTION TO PRACTICAL CHEMISTRY, INCLUD- 
ING ANALYSIS. Sixth American, from the sixth London edition, 
with numerous illustrations. 1 vol. 12mo. of 350 pp. Cloth, $2 25. 

BELLAMY'S MANUAL OF SURGICAL ANATOMY. With numerous 
illustrations. In one royal 12mo. vol. Cloth, $2 25. (Lately issued.) 
BAIRD (ROBERT). IMPRESSIONS AND EXPERIENCES OF THE 
WEST INDIES. 1 vol. royal 12mo. Cloth, 75 cents. 



HENRY C. LEA'S PUBLICATIONS. 



BRYANT (THOMAS). THE PRACTICE OF SURGERY. Second Am. 
from Second English Edition. In one handsome 8vo. vol. of over 
1000 pp., with 672 illust. Cloth, $6. 00; leather, $7.00. {Just ready.) 

BARNES (ROBERT). A PRACTICAL TREATISE ON THE DIS- 
EASES OF WOMEN. Second American, from Second English Edn. 
In one handsome 8vo. vol. of about 784 pages, with 181 illustrations, 
cloth, $4 50 ; leather, $5 50 {Just issued.) 

BURNETT (CHARLES H.) THE EAR: ITS ANATOMY. PHYSI- 
OLOGY, AND DISEASES. A Practical Treatise for the Use of 
Students and Practitioners. In one handsome 8vo vol. of 615 pp., 
with 87 illustrations. Cloth $4 50 ; leather, $5 50. 

BLANDFORD (G. FIELDING). INSANITY AND ITS TREATMENT. 
With an Appendix of the laws in force in the United States on the 
Confinement of the Insane, by Dr. Isaac Ray. In one handsome 8vo. 
vol., of 471 pages. Cloth, $3 25. 

CHARCOT (J. M.) LECTURES ON THE NERVOUS SYSTEM. With 
Illustrations. Publishing in the Medical News and Library. 
CLASSEN'S QUANTITATIVE ANALYSIS. Translated by Edgar F. 
Smith, Ph.D. In one handsome 12mo. vol. cloth. $2. {Just issued.) 
CARTER (R BRUDENELL). A PRACTICAL TREATISE ON DIS- 
EASES OF THE EYE. With additions and test-types, by John 
Green, M.D. In one handsome 8vo. vol. of about 500 pages, with 
124 illustrations. Cloth, $3 75. 
pHAMBERS (T. K.) A MANUAL OF DIET IN HEALTH AND 
^ DISEASE. In one handsome octavo volume of 310 pages. Cloth, 
$2 75. 

RESTORATIVE MEDICINE. An Harveian Annual Oration 

delivered at the Royal College of Physicians, London, June 21, 1871. 
In one small 12oio. volume. Cloth, $1 00. 

COOPER (B. B.) LECTURES ON THE PRINCIPLES AND PRACTICE 
OF SURGERY. In one large 8vo. vol. of 750 pages. Cloth, $2 00. 

pARPENTER (WM. B.) PRINCIPLES OF HUMAN PHYSIOLOGY. 
^ A new American, from the Eighth English Edition. In one large 

vol. 8vo., of 1083 pages. With 373 illustrations. Cloth, $5 50; 

leather, raised bands, $6 50. {Lately issued.) 

PRIZE ESSAY ON THE USE OF ALCOHOLIC LIQUORS IN 

HEALTH AND DISEASE. New Edition, with a Preface by D. F. 
Condie, M.D. 1 vol. 12mo. of 178 pages. Cloth, 60 cents. 

0LELAND (JOHN). A DIRECTORY FOR THE DISSECTION OF 
THE HUMAN BODY. In one small royal 12mo. vol. Cloth, $1 25. 

CENTURY OF AMERICAN MEDICINE.— A History of Medicine in 
America, 1776-1876. In one royal 12mo. vol. of 366 pages. Cloth, 
$2 25. 

0HRISTISON (ROBERT). DISPENSATORY OR COMMENTARY ON 
THE PHARMACOPEIAS OF GREAT BRITAIN AND THE 
UNITED STATES. With a Supplement by R. E. Griffith. In one 
8vo. vol. of over 1000 pages, containing 213 illustrations. Cloth, $4. 

CHURCHILL (FLEETWOOD). ON THE THEORY AND PRACTICE 
OF MIDWIFERY. With notes and additions by D. Francis Condie, 
M.D. With about 200 illustrations. In one handsome 8vo. vol. of 
nearly 700 pages. Cloth, $4; leather, $5. 

ESSAYS ON THE PUERPERAL FEVER, AND OTHER DIS- 
EASES PECULIAR TO WOMEN. In one neat octavo vol. of 
about 450 pages. Cloth, $2 50. 

0HADWICK (JAMES R.) A MANUAL OF THE DISEASES PECU- 
LIAR TO WOMEN. In one neat royal 12mo. vol. With illustra- 
tions. {Preparing.) 



4 HENRY C. LEA'S PUBLICATIONS. 



CORNIL (V.), AND RANVIER (L.). MANUAL OF PATHOLOGICAL 
HISTOLOGY. Translated, with Notes and Additions, by E. 0. 
Shakespeare, Pathologist and Ophthalmic Surgeon to the Philada. 
Hospital. In one handsome 8vo. vol. of about 600 pages, with over 
300 illustrations. (In press.) 

0DNDIE (D. FRANCIS). A PRACTICAL TREATISE ON THE DIS- 
EASES OF CHILDREN. Sixth edition, revised and enlarged. In 
one large 8vo. vol. of 800 pages. Cloth, $5 25 ; leather, $6 25. 

CLOWES (FRA.NK). AN ELEMENTARY TREATISE ON PRAC- 
TICAL CHEMISTRY AND QUALITATIVE INORGANIC ANA- 
LYSIS. Especially adapted for Laboratory Use. From the Second 
English Edition. In one royal 12mo. vol. Cloth, $2 50. (Just 
issued.) 

CTJLLERIER (A.) AN ATLAS OF VENEREAL DISEASES. Trans- 
lated and edited by Freeman J. Bumstead, M.D. A large imperial 
quarto volume, with 26 plates containing about 150 figures, beauti- 
fully colored, many of them the size of life. In one vol., strongly 
bound in cloth, $17. 
Same work, in five parts, paper covers, for mailing, $3 per part. 

CYCLOPEDIA OF PRACTICAL MEDICINE. By Dunglison, Forbes, 
Tweedie, and Conolly. In four large super-royal octavo volumes, of 
3254 double-columned pages, leather, raised bands, $15. Cloth, $11. 

CAMPBELL'S LIVES OF LORDS KENYON, ELLENBOROUGH, AND 
TENTERDEN. Being the third volume of " Campbell's Lives of 
the'Chief Justices of England." In one crown octavo vol. Cloth, $2. 

DA.LTON (J. C.) A TREATISE ON HUMAN PHYSIOLOGY. Sixth 
edition, thoroughly revised, and greatly enlarged and improved, with 
316 illustrations. In one very handsome 8vo. vol. of 830 pp. 
Cloth, $5 50; leather, $6 50. 

DWIS (F. H.) LECTURES ON CLINICAL MEDICINE. Second 
edition, revised and enlarged. In one 12mo. vol. Cloth, $1 75. 

DON QUIXOTE DE LA MANCHA. Illustrated edition. In two hand- 
some vols, crown 8vo. Cloth, $2 50 ; half morocco. $3 70. 
DEWEES (W. P.) A TREATISE ON THE DISEASES OF FEMALES. 
With illustrations. In one 8vo. vol. of 536 pages. Cloth, $3. 
DRUITT (ROBERT). THE PRINCIPLES AND PRACTICE OF MO- 
DERN SURGERY. A revised American, from the eighth London 
edition. Illustrated with 432 wood engravings. In one 8vo. vol. 
of nearly 700 pages. Cloth, $4; leather, $5. 

DUNGLISON (ROBLEY). MEDICAL LEXICON; a Dictionary of 
Medical Science. Containing a concise explanation of the various 
subjects and terms of Anatomy, Physiology, Pathology, Hygiene, 
Therapeutics, Pharmacology, Pharmacy, Surgery, Obstetrics, Medical 
Jurisprudence, and Dentistry. Notices of Climate and of Mineral 
Waters; Formulas for Officinal, Empirical, and Dietetic Preparations, 
with the accentuation and Etymology of the Terms, and the French 
and other Synonymes. In one very large royal 8vo. vol. New edi- 
tion. Cloth, $6 50 ; leather, $7 50. 
DE LA BECHE'S GEOLOGICAL OBSERVER. In one large 8vo. vol. 
of 700 pages, with 300 illustrations. Cloth, $4. 

DANA (JAMES D.) THE STRUCTURE AND CLASSIFICATION OF 
ZOOPHYTES. Withillust. on wood. In one imp. 4to. vol. Cloth, $4. 

ELLIS (GEORGE VINER). DEMONSTRATIONS IN ANATOMY. 
Being a Guide to the Knowledge of the Human Body by Dissection. 
From the eighth and revised English edition. Illustrated by 248 
engravings on wood. In one very handsome 8vo. vol. of over 700 pp. 
(In press.) 



HENRY C. LEA'S PUBLICATIONS. 5 

EMMET (THOMAS ADDIS). THE PRINCIPLES AND PRACTICE 
OF GYNECOLOGY, for the use of Students and Practitioners. In 
one large 8vo. vol. of nearly 900 pp. and more than 100 original illus- 
trations. Cloth, $5.00; leather, $6.00. (Noiv Ready.) 

ERICHSEN (IOHNE.) THE SCIENCE AND ART OF SURGERY- 
A new and improved American, from the Seventh enlarged and 
revised London edition. Revised by the Author. Illustrated with 
863 engravings on wood. In two large 8vo. vols. Cloth, $8 50 ; 
leather, raised bands, $10 50. {Just issued .) 

ENCYCLOPEDIA OF GEOGRAPHY. In three large 8vo. vols. Illus- 
trated with 83 maps and about 1100 wood-cuts. Cloth, $5. 

FINLAYSON (JAMES) CLINICAL MANUAL FOR THE STUDY 
OF MEDICAL CASES. In one handsome 8vo. vol. with numerous 
illustrations. Cloth, $2 63. {Just issued.) 

FOTHERGILL'S PRACTITIONER'S HANDBOOK OF TREATMENT. 
In one handsome 8vo. vol. of about 550 pp. Cloth, $4. (Justisstted.) 

ON THE ANTAGONISM OF THERAPEUTIC AGENTS. In 

one neat 12mo. vol. of about 200 pages. Cloth, $1. (Just issued.) 

FARQUHARSON (ROBERT). A GUIDE TO THERAPEUTICS. 
Edited, with additions, embracing the U. S. Pharmacopoeia, by 
Frank Woodbury, M.D. In one neat royal 12mo. volume. Cloth, 

$2. {Just issued.) 

FENWICK (SAMUEL). THE STUDENTS' GUIDE TO MEDICAL 
DIAGNOSIS. From the Third Revised and Enlarged London Edi- 
tion. In one vol. royal 12mo. Cloth, $2 25. 

FLETCHER'S NOTES FROM NINEVEH, AND TRAVELS IN MESO- 
POTAMIA, ASSYRIA, AND SYRIA. In one 12mo. vol. Cloth, 75 cts. 

pOX (TILBURY). EPITOME OF SKIN DISEASES, with Formula) 

■L for Students and Practitioners. Second Am. Edition, revised by the 

author. In one small 12ino. vol. Cloth, $1.38. (Now ready.) 

FLINT (AUSTIN). A TREATISE ON THE PRINCIPLES AND 
PRACTICE OF MEDICINE. Fourth edition, thoroughly revised 
and enlarged. In one large 8vo. volume of 1070 pages. Cloth, $6 ; 
leather, raised bands, $7. (Lately issued.) 

A PRACTICAL TREATISE ON THE PHYSICAL EXPLORA- 
TION OF THE CHEST, AND THE DIAGNOSIS OF DISEASES 
AFFECTING THE RESPIRATORY ORGANS. Second and revised 
edition. One 8vo. vol. of 595 pages. Cloth, $4 50. 

A PRACTICAL TREATISE ON THE DIAGNOSIS AND TREAT- 
MENT OF DISEASES OF THE HEART. Second edition, enlarged. 
In one neat 8vo. vol. of over 500 pages, $4 00. 

ON PHTHISIS : ITS MORBID ANATOMY, ETIOLOGY, etc., 

in a series of Clinical Lectures. A new work. In one handsome 8vo. 
volume. Cloth, $3 50. 

A MANUAL OF PERCUSSION AND AUSCULTATION; of the 

Physical Diagnosis of Diseases of the Lungs and Heart, a*ad of Tho- 
racic Aneurism. In one handsome royal 12mo. volume. Cloth, 
$1 75. 

MEDICAL ESSAYS. In one neat 12mo. volume. Cloth, $138. 



FOWNES (GEORGE). A MANUAL OF ELEMENTARY CHEMISTRY. 
A new American, from the enlarged English edition. In one royal 
12mo. vol. of over 1000 pages, with 177 illustrations, and one col- 
ored plate. Cloth, $2 75 ; leather, $3 25. (Just issued.) 

FULLER (HENRY). ON DISEASES OF THE LUNGS AND AIR 
PASSAGES. Their Pathology, Physical Diagnosis, Symptoms, and 
Treatment. From the second English edition. In on© 8vo vol. 
of about 500 pages. Cloth, $3 50. 



HENRY C. LEA'S PUBLICATIONS. 



GALLOWAY (ROBERT). A MANUAL OF QUALITATIVE ANAL- 
YSIS. In one 12mo. vol., cloth, $2 75. 

GLUGE (GOTTLIEB). ATLAS OF PATHOLOGICAL HISTOLOGY. 
Translated by Joseph Leidy, M.D., Professor of Anatomy in the 
University of Pennsylvania, &c. In one vol. imperial quarto, with 
320 copperplate figures, plain and colored. Cloth, $4. 

GREEN (T. HENRY). AN INTRODUCTION TO PATHOLOGY AND 
MORBID ANATOMY. Third Anier., from the fourth Lond. Ed. 
In one handsome 8vo. vol., with numerous illust. Cloth, $2 25. 

GRAY (HENRY). ANATOMY, DESCRIPTIVE AND SURGICAL. 
A new American, from the eighth and enlarged London edition. To 
which is added Holden's "Landmarks, Medicaland Surgical." In one 
large imperial 8vo. vol. of nearly 1000 pages, with 522 large and elabo- 
rate engravings on wood. Cloth, $6; leather, $7. {Jiist issued.) 

GRIFFITH (ROBERT E.) A UNIVERSAL FORMULARY, CON- 
TAINING THE METHODS OF PREPARING AND ADMINISTER- 
ING OFFICINAL AND OTHER MEDICINES. Third and Enlarged 
Edition. Edited by John M. Maisch. In one large 8vo vol of 800 
pages, double columns. Cloth, $4 50 ; leather, $5 50. 

ROSS (SAMUEL D.) A SYSTEM OF SURGERY, PATHOLOGICAL, 
DIAGNOSTIC, THERAPEUTIC, AND OPERATIVE. Illustrated 
by 1403 engravings. Fifth edition, revised and improved In two 
large imperial 8vo. vols, of over 2200 pages, strongly bound in 
leather, raised bands, $15. 

ROSS (SAMUEL D.) A PRACTICAL TREATISE ON THE Dis- 
eases, Injuries, and Malformations of the Urinary Bladder, the Pros- 
tate Gland, and the Urethra. Third Edition, thoroughly Revised 
and Condensed, by Samuel W. Gross, M.D., Surgeon to the Phila- 
delphia Hospital. In one handsome octavo volume, with about two 
hundred illustrations. Cloth, $4 50. {Lately issued.) 
— A PRACTICAL TREATISE ON FOREIGN BODIES IN THE 



G 



G 



AIR PASSAGES. In one 8vo. vol. of 468 pages. Cloth, $2 75. 

GIBSON'S INSTITUTES AND PRACTICE OF SURGERY. Intwo8vo. 
vols, of about 1000 pages, learner, $6 50. 

GOSSELIN (L.) CLINICAL LECTURES ON SURGERY. Delivered 
at the Hospital of La Charite. Translated from the French by Lewis 
A. Stiimon, M.D., Surgeon to the Presbyterian Hospital, New York. 
With illustrations. In one handsome 8vo. vol. of 350 pages. Cloth, 
$2 50. {Lately issued.) 

HABERSHON (S. O.). ON THE DISEASES OF THE ABDOMEN. 
Second American, from the third English edition. In one handsome 
8vo. volume of over 500 pages, with illustrations. {Nearly ready.) 

HAMILTON (ALLAN McLANE). NERVOUS DISEASES, THEIR 
DESCRIPTION AND TREATMENT. In one handsome 8vo vol. 
of 512 pages, with 53 illustrations. Cloth, $3 50. {Just issued.) 

HEATH (CHRISTOPHER). PRACTICAL ANATOMY ; A MANUAL 
OF DISSECTIONS. With additions, by W. W. Keen, M. D. In 1 

volume; with 247 illustrations. Cloth, $3 50; leather, $4. 

HARTSHORNE (HENRY). ESSENTIALS OF THE PRINCIPLES 
AND PRACTICE OF MEDICINE. Fourth and revised edition. 
Inonel2rao. vol. Cloth, $2 63; half bound, $2 88. {Lately issued ) 

CONSPECTUS OF THE MEDICAL SCIENCES. Comprising 

Manuals of Anatomy, Physiology, Chemistry, Materia Medica, Prac- 
tice of Medicine, Surgery, and Obstetrics. Second Edition. In one 
royal 12mo. volume of over 1000 pages, with 477 illustrations. 
Strongly bound in leather, $5 00 ; cloth, $4 25. {Lately issued.) 

A HANDBOOK OF ANATOMY AND PHYSIOLOGY. In one 

neat royal 12mo. volume, with many illustrations. Cloth, $1 75 



HENRY C. LEA'S PUBLICATIONS. 



TTOLMES (TIMOTHY). SURGERY, ITS PRINCIPLES AND PRAC- 
■"• TICE. In one handsome 8vo. volume of 1000 pages, with 411 illus- 
trations. Cloth, $6 ; leather, with raised bands, $7. (Lately issued ) 
HAMILTON (FRANK H.) A PRACTICAL TREATISE ON FRAC- 
TURES AND DISLOCATIONS. Fifth edition, carefully revised. 
In one handsome 8vo. vol. of 830 pages, with 344 illustrations. Cloth 
$5 75 ; leather, $6 75. 

HOBLYN (RICHARD D.) A DICTIONARY OF THE TERMS USED 
in Medicine and the collateral sciences, in one 

12mo. volume, of over 500 double-columned pages. Cloth, $150; 
leather, $2. 

TTOLDEN (LUTHER). LANDMARKS, MEDICAL AND SURGICAL. 
■"- From the Second English Edition. In one royal 12mo. vol. of 128 
pages. Cloth, 88 cents. (Lately issued.) 

HUDSON (A.) LECTURES ON THE STUDY OF FEVER. 1 vol. 
8vo., 316 pages. Cloth, $2 50. 

HODGE (HUGH L.) ON DISEASES PECULIAR TO WOMEN, IN- 
CLUDING DISPLACEMENTS OF THE UTERUS. Second and 
revised edition. In one 8vo. volume. Cloth, $4 50. 
THE PRINCIPLES AND PRACTICE OF OBSTETRICS. Illus- 
trated with large lithographic plates containing 159 figures from 
original photographs, and with numerous wood-cuts. In one large 
quarto vol. of 550 double-columned pages. Strongly bound in cloth, 
$14. 

HOLLAND (SIR HENRY). MEDICAL NOTES AND REFLECTIONS. 
From the third English edition. In one 8vo. vol. of about 500 pages. 
Cloth, $3 50. 

HODGES (RICHARD M.) PRACTICAL DISSECTIONS. Second edi- 
tion. In one neat royal 12mo. vol., half bound, $2. 

HUGHES. SCRIPTURE GEOGRAPHY AND HISTORY, with 12 
colored maps. In 1 vol. 12mo. Cloth, $1. 

H3RNER (WILLIAM E.) SPECIAL ANATOMY AND HISTOLOGY. 
Eighth edition, revised and modified. In two large 8vo. vols, of over 
1000 pages, containing 300 wood-cuts. Cloth, $6. 

HILL (BERKELEY). SYPHILIS AND LOCAL CONTAGIOUS DIS- 
ORDERS. In one 8vo. volume of 467 pages. Cloth, $3 25. 

HILLTER (THOMAS). HAND-BOOK OF SKIN DISEASES. Second 
Edition In one neat royal 12mo. volume of about 300 pp., with two 
plates. Cloth, $2 25. 

HALL (CRS. M.) LIVES OF THE QUEENS OF ENGLAND BEFORE 
THE NORMAN CONQUEST. In one handsome 8vo. vol. Cloth, 
$2 25; crimson cloth, $2 50; half morocco, $3. 

TONES (0. HANDFIELD). CLINICAL OBSERVATIONS ON FUNC- 
U TIONAL NERVOUS DISORDERS. Second American Edition. In 
one 8vo. vol. of 348 pages. Cloth, $3 25. 

KIRKES (WILLIAM SENHOUSE). A MANUAL OF PHYSIOLOGY. 
A new American, from the eighth London edition. One vol., with 
manyillus., 12mo. Cloth, $3 25; leather, $3 75. 

KNAPP (F.) TECHNOLOGY : OR CHEMISTRY, APPLIED TO THE 
ARTS AND TO MANUFACTURES, with American additions, by 
Prof. Walter R. Johnson. In two 8vo. vols., with 500 ill. Cloth, $6. 

KENNEDY'S MEMOIRS OF THE LIFE OF WILLIAM WIRT. In 
two vols. 12mo. Cloth, $2. 

T EE (HENRY) ON SYPHILIS. In one 8vo. vol. Cloth, $2 25. 



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LEA (HENRY C.) SUPERSTITION AND FORCE ; ESSAYS ON THE 
WAGER OF LAW, THE WAGER OF BATTLE, THE ORDEAL, 
AND TORTURE. Third edition, thoroughly revised and enlarged. 
In one handsome royal 12mo. vol. Cloth, $2 50. (Just issued.) 
T EA (HENRY C.) STUDIES IN CHURCH HISTORY. The Rise of 
J-J the Temporal Power — Benefit of Clergj' — Excommunication. In 
one handsome 12mo. vol. of 515 pp. Cloth, $2 75. 

AN HISTORICAL SKETCH OF SACERDOTAL CELIBACY 

IN THE CHRISTIAN CHURCH. In one handsome octavo volume 

of 602 pages. Cloth, $3 75. 

LINCOLN (D. F.) ELECTRO-THERAPEUTICS. A Condensed Man- 
ual of Medical Electricity. In one neat royal 12mo. volume, with 
illustrations. Cloth, $1 50. 

LA ROCHE (R.) YELLOW FEVER. In two 8vo. vols, of nearly 1500 
pages. Cloth, $7. 
PNEUMONIA. In one 8vo. vol. of 500 pages. Cloth, $3. 

LEISHMAN (WILLIAM). A SYSTEM OF MIDWIFERY. Includ- 
ing the Diseases of Pregnancy and the Puerperal State. Second 
American, from the Second English Edition. With additions, hy 
J. S. Parry, M.D. In one very handsome 8vo. vol. of 800 pages and 
200 illustrations. Cloth, $5 ; leather, $6. {Jiost issued.) 

LAURENCE (J. Z.) AND MOON (ROBERT C.) A HANDY-BOOK 
OF OPHTHALMIC SURGERY. Second edition, revised by Mr. 
Laurence. With numerous illus. In one 8vo. vol. Cloth, $2 75. 
T EHMANN (C. G.) PHYSIOLOGICAL CHEMISTRY. Translated by 
J-J George F. Day, M.D. With plates, and nearly 200 illustrations. 
In two large 8vo. vols., containing 1200 pages. Cloth, $6. 

A MANUAL OF CHEMICAL PHYSIOLOGY. In one very 

handsome 8vo. vol. of 336 pages. Cloth, $2 25. 

LAWSON (GEORGE). INJURIES OF THE EYE, ORBIT, AND EYE- 
LIDS, with about 100 illustrations. From the last English edition. 
In one handsome 8vo. vol. Cloth, $3 50. 

LUDLOW (J. L.) A MANUAL OF EXAMINATIONS UPON ANA- 
TOMY, PHYSIOLOGY, SURGERY, PRACTICE OF MEDICINE, 
OBSTETRICS, MATERIA MEDICA, CHEMISTRY, PHARMACY, 
AND THERAPEUTICS. To which is added a Medical Formulary. 
Third edition. In one royal 12mo. vol. of over 800 pages. Cloth, 
$3 25 ; leather, $3 75. 

LYNCH (W. F.) A NARRATIVE OF THE UNITED STATES EX- 
PEDITION TO THE DEAD SEA AND RIVER JORDAN. In one 
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Same Work, condensed edition. One vol. royal 12mo. Cloth, $1. 

LYONS (ROBERT D.) A TREATISE ON FEVER. In one neat 8vo. 
vol. of 362 pages. Cloth, $2 25. 
TWTEIGS (CHAS. D.) A ON THE NATURE, SIGNS, AND TREATMENT 



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from the third Edinburgh edition. In one large 8vo. vol. of 700 
pages, with 240 illustrations. Cloth, $3 75. 

THE PRACTICE OF SURGERY. Fourth American, from the 



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364 illustrations. Cloth, S3 75. 

MONTGOMERY (W. F.) AN EXPOSITION OF THE SIGNS AND 
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TWTIRABEAU; A LIFE HISTORY. In one 12mo. vol. Cloth, 75 cts. 

MACFARLAND'S TURKEY AND ITS DESTINY. In 2 vols, royal 
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MARSH (MRS.) A HISTORY OF THE PROTESTANT REFORMA- 
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NEILL (JOHN) AND SMITH (FRANCIS G.) COMPENDIUM OF 
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Cloth, $4; leather, raised bands, $4 75. 

NELIGAN(J. MOORE). AN ATLAS OF CUTANEOUS DISEASES. In 
one quarto volume, with beautifully colored plates, &c. Cloth, $5 50. 

PLAYFAIR (W. S.) A TREATISE ON THE SCIENCE AND PRAC- 
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PAVY (F. W.) A TREATISE ON THE FUNCTION OF DIGESTION, 
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piRRIE (WILLIAM) THE PRINCIPLES AND PRACTICE OF SUR- 
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ROBERTS (WILLIAM). A PRACTICAL TREATISE ON URINARY 
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RIGBY (EDWARD). A SYSTEM OF MIDWIFERY. Second Ameri- 
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OCHAFER (EDWARD ALBERT). A COURSE OF PRACTICAL HIS- 
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STIMSON (LEWIS A.) A MANUAL OF OPERATIVE SURGERY. 
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with illustrations. Cloth, $1 25. 

STURGES (OCTAVIUS). AN INTRODUCTION TO THE STUDY 
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OMITH (EUSTACE). ON THE WASTING DISEASES OF CHILDREN. 
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SARGENT (F. W.) ON BANDAGING AND OTHER OPERATIONS 
OF MINOR SURGERY. New edition, with an additional chapter 
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SMITH (J. LEWIS). A TREATISE ON THE DISEASES OF IN- 
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SHARPEY (WILLIAM) AND QUAIN (JONES AND RICHARD). 
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SKEY (FREDERIC C.) OPERATIVE SURGERY. In one 8vo. vol. 
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SLADE (D. D.) DIPHTHERIA ; ITS NATURE AND TREATMENT. 
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SMITH (EDWARD). CONSUMPTION; ITS EARLY AND REME- 
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STILLE (ALFRED). THERAPEUTICS AND MATERIA MEDIC A. 
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STILLE (ALFRED) AND MAISCH (JOHN M.) THE NATIONAL 
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SMALL BOOKS ON GREAT SUBJECTS. Twelve works ; each one 10 
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SCHOEDLER (FREDERICK) AND MEDLOCK (HENRY). WONDERS 
OF NATURE. An elementary introduction to the Sciences of Physics, 
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and Physiology. Translated from the German by H. Medlock. In 
one neat 8vo. vol., with 679 illustrations. Cloth, $3. 
OTOKES (W.) LECTURES ON FEVER. In one 8vo. vol. Cloth, $2. 

STRICKLAND (AGNES). LIVES OF THE QUEENS OF HENRY 
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MEMOIRS OF ELIZABETH, SECOND QUEEN REGNANT OF 

ENGLAND AND IRELAND. In onecrown octavo vol., extracloth, 
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TANNER (THOMAS HAWKES). A MANUAL OF CLINICAL MEDI- 
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second revised English edition. Edited by Tilbury Fox, M.D. In 
one handsome 12mo. volume of 366 pp. Cloth, $1 50. 

ON THE SIGNS AND DISEASES OF PREGNANCY. From 

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illustrations on wood. In one vol. 8vo. of about 500 pages. Cloth, 
$4 25. 

TUKE (DANIEL HACK). INFLUENCE OF THE MIND UPON THE 
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TAYLOR (ALFRED S.) MEDICAL JURISPRUDENCE. Seventh 
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— : PRINCIPLES AND PRACTICE OF MEDICAL JURISPRU- 
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ON POISONS IN RELATION TO MEDICINE AND MEDICAL 



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THOMAS (T. GAILLARD). A PRACTICAL TREATISE ON THE 
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TODD (ROBERT BENTLEY) . CLINICAL LECTURES ON CERTAIN 
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THOMPSON (SIR HENRY). THE PATHOLOGY AND TREATMENT 
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From the third English edition. In one 8vo. vol. of 359 pp., with 
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THOMPSON (SIR HENRTO. CLINICAL LECTURES ON DISEASES 
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WALSHE (W. H.) PRACTICAL TREATISE ON THE DISEASES 
OF THE HEART AND GREAT VESSELS. Third American from 
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Cloth, $3. 

WATSON (THOMAS). LECTURES ON THE PRINCIPLES AND 
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WOHLER'S OUTLINES OF ORGANIC CHEMISTRY. Translated 
from the 8th German edition, by Ira Remsen, M.D. In one neat 
12mo. vol. Cloth, $3 00. {Lately issued.) 

ELLS (J. SOELBERG). A TREATISE ON THE DISEASES OF 
THE EYE. Third edition, revised by the author. In one large and 
handsome octavo vol., with 6 colored plates and many wood-cuts, 
also selections from the test-types of Jaeger and Snellen. {Pre- 
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HAT TO OBSERVE AT THE BEDSIDE AND AFTER DEATH 
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EST (CHARLES). LECTURES ON THE DISEASES PECULIAR 
TO WOMEN. Third American from the Third English edition. In 
one octavo volume of 550 pages. Cloth, $3 75 ; leather, $4 75. 

LECTURES ON THE DISEASES OF INFANCY AND CHILD- 
HOOD. Fifth American from the sixth revised English edition. In 
one large 8vo. vol. of 670 closely printed pages. Cloth, $4 50 ; lea- 
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ON SOME DISORDERS OF THE NERVOUS SYSTEM IN 

CHILDHOOD. From the London Edition. In one small 12mo. 
volume. Cloth, $1. 

WILLIAMS (CHARLES J. B. and C. T.) PULMONARY CONSUMP- 
TION : ITS NATURE, VARIETIES, AND TREATMENT. In 

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WILSON (ERASMUS). A SYSTEM OF HUMAN ANATOMY. A 
new and revised American from the last English edition. Illustrated 
with 397 engravings on wood. In one handsome 8vo. vol. of over 
600 pages. Cloth, $4 ; leather, $5. 

THE STUDENT'S BOOK OF CUTANEOUS MEDICINE. In 

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WINCKEL ON PATHOLOGY AND TREATMENT OF CHILDBED. 
With Additions by the Author. Translated by Chadwick. In one 
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WOODBURY (FRANK). A HANDBOOK OF THE PRINCIPLES 
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